Basic Information
Provider Information
NPI: 1043510902
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAPROLET
FirstName: SHERALYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HADDEN
OtherFirstName: SHERALYN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3200 E CAMELBACK RD STE 250
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850182327
CountryCode: US
TelephoneNumber: 6029331814
FaxNumber:  
Practice Location
Address1: 1919 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850167710
CountryCode: US
TelephoneNumber: 6029336345
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2010
LastUpdateDate: 12/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN131779AZN Nursing Service ProvidersRegistered Nurse 
363LN0000XAP3864AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


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