Provider Demographics
NPI:1578074134
Name:GARCIA KENDALL, BIANCA PILAR (FNP-C)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:PILAR
Last Name:GARCIA KENDALL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 E SOUTHERN AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2677
Mailing Address - Country:US
Mailing Address - Phone:480-981-6100
Mailing Address - Fax:
Practice Address - Street 1:6130 E BROWN RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4960
Practice Address - Country:US
Practice Address - Phone:480-807-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-22
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily