Individual
MR. ROBERT KALONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
4455 S I 19 FRONTAGE RD, GREEN VALLEY, AZ 85614-5884
(520) 393-4700
Mailing address
5215 W LA SALLE ST, LAVEEN, AZ 85339-1906
(701) 200-7166
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
226732
AZ
363LA2100X
Acute Care Nurse Practitioner
226732
AZ
363LA2200X
Adult Health Nurse Practitioner
226732
AZ
363LC0200X
Critical Care Medicine Nurse Practitioner
226732
AZ
363LG0600X
Gerontology Nurse Practitioner
226732
AZ
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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