Provider Demographics
NPI:1790194967
Name:KIERNAN, JODI MARIE MOLTISANTI (PNP)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:MARIE MOLTISANTI
Last Name:KIERNAN
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Gender:F
Credentials:PNP
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Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:PHOENIX CHILDREN'S HOSPITAL HEART CENTER
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-933-3366
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:PHOENIX CHILDREN'S HOSPITAL HEART CENTER
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:917-921-7966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2020-08-04
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Provider Licenses
StateLicense IDTaxonomies
AZRN180535363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics