Provider Demographics
NPI:1457358764
Name:LUPONE, KATHLEEN A (RN,FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:A
Last Name:LUPONE
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Gender:F
Credentials:RN,FNP-C
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Mailing Address - Street 1:5017 W ASTER DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85304-2013
Mailing Address - Country:US
Mailing Address - Phone:602-978-6349
Mailing Address - Fax:602-978-6349
Practice Address - Street 1:5111 N SCOTTSDALE RD STE 203
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-7077
Practice Address - Country:US
Practice Address - Phone:480-771-3400
Practice Address - Fax:602-753-3042
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2019-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZRN040006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily