Basic Information
| Provider Information | |||||||||
| NPI: | 1750057022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STAPLETON | ||||||||
| FirstName: | KADI | ||||||||
| MiddleName: | EVE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 W UTOPIA RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6236834462 | ||||||||
| FaxNumber: | 6236834963 | ||||||||
| Practice Location | |||||||||
| Address1: | 1626 S PRIEST DR STE 104 | ||||||||
| Address2: | |||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852816598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808827320 | ||||||||
| FaxNumber: | 4809677920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2021 | ||||||||
| LastUpdateDate: | 07/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 262378 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.