Individual
MRS. KATHRYNE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2113 E GLENCOVE ST, MESA, AZ 85213-4610
(530) 417-1114
Mailing address
2113 E GLENCOVE ST, MESA, AZ 85213-4610
(530) 417-1114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
218171
AZ
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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