Provider Demographics
NPI:1528877446
Name:ALI, KRISTAL ANNE (APRN)
Entity type:Individual
Prefix:
First Name:KRISTAL
Middle Name:ANNE
Last Name:ALI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N DOBSON RD UNIT 14
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6973
Mailing Address - Country:US
Mailing Address - Phone:747-206-3685
Mailing Address - Fax:
Practice Address - Street 1:700 N DOBSON RD UNIT 14
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6973
Practice Address - Country:US
Practice Address - Phone:747-206-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ317648363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care