Provider Demographics
NPI:1346614385
Name:KIRCHOFF, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KIRCHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W CONTINENTAL RD STE 141
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-3666
Mailing Address - Country:US
Mailing Address - Phone:520-628-4000
Mailing Address - Fax:520-547-7003
Practice Address - Street 1:275 W CONTINENTAL RD STE 141
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85622-3666
Practice Address - Country:US
Practice Address - Phone:520-628-4000
Practice Address - Fax:520-547-7003
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ158401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical