Individual
JACQUELINE KIENHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
BANNER MD ANDERSON CANCER CENTER, 2946 E. BANNER GATEWAY DRIVE, GILBERT, AZ 85234
(480) 256-6444
(480) 256-3682
Mailing address
BANNER MD ANDERSON CANCER CENTER, 2940 E. BANNER GATEWAY DRIVE, GILBERT, AZ 85234
(480) 256-6444
(480) 256-3682
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
5467
AZ
363AM0700X
Medical Physician Assistant
PA22903
CA
363AS0400X
Surgical Physician Assistant
5467
AZ
364SF0001X
Family Health Clinical Nurse Specialist
PA22903
CA
Other
Enumeration date
06/05/2013
Last updated
03/18/2020
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