Individual
KIRSTINE A. BLACKSHEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1209 N MILLER RD, BUCKEYE, AZ 85326-1043
(623) 386-5785
(623) 386-6673
Mailing address
9250 N 3RD ST, SUITE 4010, PHOENIX, AZ 85020-2437
(602) 633-3848
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2967
AZ
Other
Enumeration date
03/16/2006
Last updated
03/07/2023
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