Provider Demographics
NPI:1285955823
Name:JANOSEK-ALBRIGHT, KIRSTEN JANNA CHIMWEMWE (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:JANNA CHIMWEMWE
Last Name:JANOSEK-ALBRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:JANNA CHIMWEMWE
Other - Last Name:JANOSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17560 N 75TH AVE
Mailing Address - Street 2:SUITE 440
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5983
Mailing Address - Country:US
Mailing Address - Phone:623-512-4390
Mailing Address - Fax:623-512-4391
Practice Address - Street 1:17560 N 75TH AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5983
Practice Address - Country:US
Practice Address - Phone:623-512-4390
Practice Address - Fax:623-512-4391
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50234208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ012341Medicaid
AZZ176638Medicare PIN