Provider Demographics
NPI:1861469520
Name:FLANDERS, KIM L (CNM)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:L
Last Name:FLANDERS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:L
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:6707 N 19TH AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1106
Mailing Address - Country:US
Mailing Address - Phone:602-283-3668
Mailing Address - Fax:602-258-1710
Practice Address - Street 1:6707 N 19TH AVE STE 222
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1106
Practice Address - Country:US
Practice Address - Phone:602-283-3668
Practice Address - Fax:602-258-1710
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626869367A00000X
AZNP4243367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife