Individual
ANNETTE KIETUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7797 W PARADISE LN STE 130, PEORIA, AZ 85382-5011
(623) 337-7831
(855) 978-1317
Mailing address
302 W APACHE ST, PHOENIX, AZ 85003-2729
(623) 337-7831
(855) 978-1317
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
RN200321
AZ
363L00000X
Nurse Practitioner
251944
AZ
Other
Enumeration date
01/06/2021
Last updated
01/21/2025
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