Basic Information
Provider Information
NPI: 1538275250
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIONDO
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ANP-C
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 13640 N PLAZA DEL RIO BLVD
Address2:  
City: PEORIA
State: AZ
PostalCode: 853814846
CountryCode: US
TelephoneNumber: 6238763800
FaxNumber: 6238763862
Practice Location
Address1: 18444 N 25TH AVE STE 210
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850231264
CountryCode: US
TelephoneNumber: 8669742673
FaxNumber: 8669392673
Other Information
ProviderEnumerationDate: 08/23/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XAP2480AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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