Basic Information
| Provider Information | |||||||||
| NPI: | 1720044969 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHOJNACKI | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN, CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 31235 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857511235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203242308 | ||||||||
| FaxNumber: | 5203241406 | ||||||||
| Practice Location | |||||||||
| Address1: | 535 N WILMOT RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857112600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206949988 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 01/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 2000160132 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 363LP0200X | AP7296 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 200310940A | 05 | KS | MEDICAID | 427237201 | 05 | MO | MEDICAID | 929431 | 01 | AZ | AHCCCS | OTHER |