Provider Demographics
NPI:1972337939
Name:WHEELER, KATELYN PHILLIPS (RN)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:PHILLIPS
Last Name:WHEELER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 E OSBORN RD APT 107W
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7462
Mailing Address - Country:US
Mailing Address - Phone:410-926-7651
Mailing Address - Fax:
Practice Address - Street 1:7701 E OSBORN RD APT 107W
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7462
Practice Address - Country:US
Practice Address - Phone:410-926-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261875163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse