Provider Demographics
NPI:1194905885
Name:O'BRIEN-KINNE, JERE K (ARNP)
Entity type:Individual
Prefix:MS
First Name:JERE
Middle Name:K
Last Name:O'BRIEN-KINNE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:1220 S HIGLEY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4000
Mailing Address - Country:US
Mailing Address - Phone:480-615-2010
Mailing Address - Fax:480-632-2786
Practice Address - Street 1:3493 S MERCY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0434
Practice Address - Country:US
Practice Address - Phone:480-732-0044
Practice Address - Fax:480-632-2786
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN165700/AP3905363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics