Provider Demographics
NPI:1447742127
Name:VAN ORDEN, KIMBERLEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEE
Middle Name:
Last Name:VAN ORDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVENUE, 6TH FLOOR
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3838 N CAMPBELL AVENUE, BLDG 2, CLINIC E
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-594-8888
Practice Address - Fax:520-694-3941
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR767182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology