ANDREA JEANNE KLOCK (NPI# 1629575246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629575246 |
Entity Type | Individual |
Full Name | ANDREA JEANNE KLOCK |
Credential | FNP-C |
Practice Address |
2525 E Roosevelt St Phoenix AZ 85008 |
Mailing Address |
2929 E Thomas Rd Phoenix AZ 85016-8034 |
Practice Telephone | 6023441015 |
Practice Fax Number | 6023441112 |
Mailing Telephone | 6024705000 |
Enumeration Date | 2018-04-10 |
Last Update Date | 2018-06-27 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP11361 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP11361 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2525 E ROOSEVELT ST |
City | PHOENIX |
State | AZ |
Zip Code | 85008 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083698955 | Surabhi Amar | Internal Medicine | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2005-12-02 |
1982202982 | Katherine Brown | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-10-12 |
1295360287 | Stephanie Nicole Steeves | Dietitian, Registered | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2020-03-10 |
1154967602 | Danielle Fleck | Occupational Therapist | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2019-11-19 |
1336614858 | Teresa Dejesus Loera | Registered Nurse | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-10-11 |
1518445519 | Ari Blechner | Counselor | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-08-01 |
1194211755 | Adrienne Anne Jean Robb | Student in an Organized Health Care Education/Training Program | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2018-07-06 |
1003320904 | Sarah Taraborelli | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-11-30 |
1538680079 | Tessa Bowie | Physician Assistant | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-07-06 |
1295255669 | Meily Arevalo | Internal Medicine | 2525 E Roosevelt St, Phoenix, AZ 85008-4948 | 2017-06-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
Find all providers in zip 85008 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407456783 | Brenna Michelle Clements | Nurse Practitioner | 3226 W Donatello Dr, Phoenix, AZ 85086-2200 | 2020-10-27 |
1932712825 | Grace Wanjiru Karanja Adams | Nurse Practitioner | 200 E Thomas Rd Unit 217, Phoenix, AZ 85012-1182 | 2020-08-28 |
1649895574 | Jozzette Elaine Rubio | Nurse Practitioner | 1924 E Vineyard Rd, Phoenix, AZ 85042-5793 | 2020-06-16 |
1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
1568087955 | Christa Ann Colvin | Nurse Practitioner | 6800 E Mayo Blvd Apt 1211, Phoenix, AZ 85054-5619 | 2020-06-10 |
1497378541 | Sharon Uchechi Joshua | Nurse Practitioner | 9117 W Virginia Ave, Phoenix, AZ 85037-4233 | 2020-05-23 |
1992326102 | Ashley Elizabeth Hall | Nurse Practitioner | 15810 N 18th St, Phoenix, AZ 85022-3302 | 2020-04-28 |
1750916797 | Sebastian Freeman Smith | Nurse Practitioner | 2716 W Cedarwood Ln, Phoenix, AZ 85045-2224 | 2020-03-10 |
1295365724 | Jessica Veasy | Nurse Practitioner | 7251 N 23rd Ave, Phoenix, AZ 85021-7714 | 2020-01-23 |
1568092526 | Anuradha Lingamneni | Nurse Practitioner | 2313 E Dry Wood Rd, Phoenix, AZ 85024-8688 | 2020-01-18 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.