Individual
KIM ANDERSON GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP, MS
Contact information
Practice address
590 S OCOTILLO AVE, BENSON, AZ 85602-6405
(520) 586-7080
(520) 586-3163
Mailing address
489 N ARROYO BLVD, NOGALES, AZ 85621-2644
(520) 287-4713
(520) 287-9794
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
PNPAP0073
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
488462
AHCCCS #
AZ
Enumeration date
09/27/2006
Last updated
07/09/2007
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