Provider Demographics
NPI:1083682942
Name:KAPLAN, MARY P (ANP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:P
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:PERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6116 E ARBOR AVE
Mailing Address - Street 2:112
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-6107
Mailing Address - Country:US
Mailing Address - Phone:480-641-5400
Mailing Address - Fax:
Practice Address - Street 1:5859 W TALAVI BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1870
Practice Address - Country:US
Practice Address - Phone:602-298-7777
Practice Address - Fax:623-930-6060
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1392363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
P39785Medicare UPIN