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Contact Information

KACHINA FAMILY PRACTICE PA
16611 S 40TH ST
SUITE 120
PHOENIX, AZ85048
 Phone: 480-706-4100
 Fax: 480-706-2600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for KACHINA FAMILY PRACTICE PA · (Female)

NPI # 1467508432
Status Active
Credentials
Entity Individual
Enumeration date 01/25/2007
Last updated 04/30/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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