Individual
KATHLEEN A OLDFATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8050 E LAKESIDE PKWY, TUCSON, AZ 85730-1254
(520) 792-3293
Mailing address
1477 W COMMERCE CT, TUCSON, AZ 85746-6016
(207) 923-2935
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN 033432
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621765
—
AZ
01
—
AP3272
LICENSE
AZ
Enumeration date
11/20/2006
Last updated
09/20/2021
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