| Doctor Name: | KATHY DIANE TIESSEN |
| NPI Number: | 1023106218 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | RN135006 |
| Business Practice Address: | 1400 N Eleven Mile Corner Rd Casa Grande, AZ - 852229187 |
| Business Phone Number: | 5207236700 |
| Business Fax Number: | 5207237232 |
| Mailing Address: | Po Box 3125, ELEVEN MILE CORNER |
| State: | AZ |
| Postal Code: | 852220125 |
| Phone Number: | 5207236700 |
| Fax Number: | 5207237232 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | RN135006 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |