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KATHLEEN A OLDFATHER RN, MS

Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1487728622

Individual Registrant:
 KATHLEEN A OLDFATHER RN, MS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
430 N CORONADO BLVD  CLIFTON, AZ 85533-8086 US
Tel: 928-865-4531  Fax: 928-865-4821

Contact information for business:
489 N ARROYO BLVD  NOGALES, AZ 85621-2644 US
Tel: 520-287-4713  Fax: 520-287-9794

Registration Information:
NPI: 1487728622
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LP0808XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Psychiatric/Mental Health
AZRN 033432

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AHCCCS621765AZ01




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