Provider Demographics
NPI:1881617835
Name:MAGEE, KYRIE H (NP)
Entity type:Individual
Prefix:
First Name:KYRIE
Middle Name:H
Last Name:MAGEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KYRIE
Other - Middle Name:L
Other - Last Name:HOSPODAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13400 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5452
Mailing Address - Country:US
Mailing Address - Phone:480-301-8000
Mailing Address - Fax:
Practice Address - Street 1:13400 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259
Practice Address - Country:US
Practice Address - Phone:480-301-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN132580363L00000X
AZAP2461363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00624824OtherRAILROAD MEDICARE
AZ121916Medicaid
AZZ110713Medicare PIN
Q71047Medicare UPIN