Organization
FLAGSTAFF FIRST ASSIST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE M KYPTA NP, RNFA (PRESIDENT)
(928) 714-9379
Entity
Organization
Contact information
Practice address
2050 E CHISHOLM TRL, FLAGSTAFF, AZ 86001-9328
(928) 714-9379
Mailing address
2050 E CHISHOLM TRL, FLAGSTAFF, AZ 86001-9328
(928) 714-9379
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8050
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN105443
RNFA
AZ
01
—
Z180806
MEDICARE
AZ
Enumeration date
06/10/2011
Last updated
11/05/2015
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