Individual
KIMBERLY A WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,FNP
Contact information
Practice address
19829 N 27TH AVE, PHOENIX, AZ 85027-4001
(623) 516-4400
(623) 516-4401
Mailing address
9416 W COLTER ST, GLENDALE, AZ 85305-3373
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
146118
AZ
207QA0505X
Adult Medicine Physician
Primary
219280
AZ
Other
Enumeration date
11/21/2017
Last updated
11/13/2018
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