Provider Demographics
NPI:1396380366
Name:DIGIAMMARINO, KATHRYN (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DIGIAMMARINO
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8444 E INDIAN SCHOOL RD APT A3011
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3066
Mailing Address - Country:US
Mailing Address - Phone:978-239-6123
Mailing Address - Fax:
Practice Address - Street 1:560 N CAMINO MERCADO STE 7
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5759
Practice Address - Country:US
Practice Address - Phone:631-352-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ232607363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily