Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 37530 | SC |
Y | 2086S0102X | Surgical Critical Care | 58056 | AZ |
N | 2086S0102X | Surgical Critical Care | A102536 | CA |
NPI | 1124204177 |
---|---|
Provider Name | Dr. Meghann Lee Kaiser |
First Address | Phoenix, AZ 85032-3356 |
Second Address | Phoenix, AZ 85032-3356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2008 |
Last Update Date | 20/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1861707770 | (05) | CA |
549539 | (05) | AZ |
Q0149N | (05) | SC |