Provider Demographics
NPI:1760617849
Name:LANDINO, KIMBERLY MARY (ND)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MARY
Last Name:LANDINO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 S RURAL RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1411
Mailing Address - Country:US
Mailing Address - Phone:480-720-3045
Mailing Address - Fax:480-966-2628
Practice Address - Street 1:2226 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1411
Practice Address - Country:US
Practice Address - Phone:480-720-3045
Practice Address - Fax:480-966-2628
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01-657175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath