Provider Demographics
NPI:1285951913
Name:AUSTIN, KATHLEEN G (ARNP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:G
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX CR
Mailing Address - Street 2:
Mailing Address - City:BISBEE
Mailing Address - State:AZ
Mailing Address - Zip Code:85603-0195
Mailing Address - Country:US
Mailing Address - Phone:520-234-7589
Mailing Address - Fax:520-319-1699
Practice Address - Street 1:4099 E 22ND ST STE 107
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-5300
Practice Address - Country:US
Practice Address - Phone:520-323-4661
Practice Address - Fax:520-319-1699
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN054246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily