Individual
KATHLEEN DAWN IVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5501 N 19TH AVE STE 103, PHOENIX, AZ 85015-2451
(602) 589-0500
(602) 314-4552
Mailing address
5501 N 19TH AVE STE 103, PHOENIX, AZ 85015-2451
(602) 589-0500
(602) 314-4552
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP7926
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086118
—
AZ
Enumeration date
06/30/2015
Last updated
06/16/2020
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