Provider Demographics
NPI:1003156654
Name:KOLODZIEJ, KRISTIN CAROL (FNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:CAROL
Last Name:KOLODZIEJ
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:CAROL
Other - Last Name:LOSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 E ROSE GARDEN LN UNIT 71351
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-7715
Mailing Address - Country:US
Mailing Address - Phone:602-418-0098
Mailing Address - Fax:
Practice Address - Street 1:2550 E ROSE GARDEN LN UNIT 71351
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-7715
Practice Address - Country:US
Practice Address - Phone:480-448-0356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN164694163W00000X
AZ323122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse