Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0271 | AZ |
Y | 222Z00000X | Podiatrist | 0271 | AZ |
NPI | 1033176631 |
---|---|
Provider Name | Kathleen M Stone |
First Address | Peoria, AZ 85383-4361 |
Second Address | Peoria, AZ 85383-4361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 04/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70056901 | (05) | AZ |
T42190 | (02) | AZ |