MRS. KAY LYNN SOUTHWELL (NPI# 1730320623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730320623 |
| Entity Type | Individual |
| Full Name | MRS. KAY LYNN SOUTHWELL |
| Other Name | KAY LYNN SOUTHERN |
| Credential | NP-C |
| Practice Address |
6242 E Arbor Ave Suite 111 Mesa AZ 85206-2809 |
| Mailing Address |
6242 E Arbor Ave Suite 111 Mesa AZ 85206-1309 |
| Practice Telephone | 4806108183 |
| Practice Fax Number | 4806108566 |
| Mailing Telephone | 4806108183 |
| Mailing Fax Number | 4806108566 |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2017-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704216251 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE PART B | 0B56065 | 01 |
| AZ | MEDICARE PART B | 0B56065 | 01 |
| Street Address |
6242 E ARBOR AVE SUITE 111 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864202 | Soma Care, LLC | Nurse Practitioner | 6944 E Broadway Rd Ste A, Mesa, AZ 85208-1916 | 2020-08-31 |
| 1245851955 | Amy Rachelle Dunn | Nurse Practitioner | 7563 E Plata Ave, Mesa, AZ 85212-9729 | 2020-05-04 |
| 1326683376 | Little Sanctuary Health Center | Nurse Practitioner | 840 W Southern Ave, Mesa, AZ 85210-4901 | 2019-11-14 |
| 1306356746 | Christine Elizabeth Claybrook | Nurse Practitioner | 6859 E Rembrandt Ave Ste 117, Mesa, AZ 85212-3630 | 2017-10-11 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1306491113 | Abigail Lee Moreno | Nurse Practitioner | 7525 E Broadway Rd Ste 11, Mesa, AZ 85208-1156 | 2019-08-08 |
| 1932623469 | John Risi | Nurse Practitioner | 2266 S Dobson Rd Ste 200, Mesa, AZ 85202 | 2017-07-26 |
| 1154774305 | Mesa Physical Medicine Pllc | Nurse Practitioner | 2919 S Ellsworth Rd, Suite 102, Mesa, AZ 85212-2164 | 2016-07-22 |
| 1720467418 | Sung E Cho | Nurse Practitioner | 1705 W Main St, Mesa, AZ 85201-6920 | 2015-05-27 |
| 1770810715 | Priscilla Marie Luong | Nurse Practitioner | 5602 E Main St, Mesa, AZ 85205-8813 | 2009-11-12 |
| Find all providers in MESA | ||||
Please comment or provide details below to improve the information on MRS. KAY LYNN SOUTHWELL.
| 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.