Basic Information
| Provider Information | |||||||||
| NPI: | 1427432939 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRMPOTIC | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | AG-ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1331 N 7TH ST | ||||||||
| Address2: | SUITE 375 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023070070 | ||||||||
| FaxNumber: | 6023070080 | ||||||||
| Practice Location | |||||||||
| Address1: | 1331 N 7TH ST | ||||||||
| Address2: | SUITE 375 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023070070 | ||||||||
| FaxNumber: | 6023070080 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2015 | ||||||||
| LastUpdateDate: | 07/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2100X | AP7821 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Acute Care |
No ID Information.