Doctor Name: | KATHERINE J WEIDENBACH |
NPI Number: | 1467481135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN114116 |
Business Practice Address: | 10565 N Tatum Blvd Suite B-116 Paradise Valley, AZ - 852531095 |
Business Phone Number: | 4809913203 |
Business Fax Number: | 4809913997 |
Mailing Address: | 7425 E Shea Blvd Ste 110, SCOTTSDALE |
State: | AZ |
Postal Code: | 852606411 |
Phone Number: | 4809488400 |
Fax Number: | 4809488401 |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 07/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN114116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |