Provider Demographics
NPI:1952556599
Name:GARAY, KIM ERICA (NP)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:ERICA
Last Name:GARAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8164 E WINDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6447
Mailing Address - Country:US
Mailing Address - Phone:480-658-2001
Mailing Address - Fax:
Practice Address - Street 1:1432 S DOBSON RD
Practice Address - Street 2:SUITE 402
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4768
Practice Address - Country:US
Practice Address - Phone:480-412-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004586N163WP0000X
AZAP5144363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WP0000XNursing Service ProvidersRegistered NursePain Management