Kimberly Wardle, M.S., CCC-SLP

Key facts

NPI

1144701202

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

SLP10682 (AZ)

Practice address

2250 N Craycroft Rd
Tucson, AZ 85712-2802

Phone

(520) 733-8700

NPI assigned

Aug 27, 2018

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 27, 2018.

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1144701202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 E SASCHA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857488177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122802",
            "telephone_number": "520-733-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLE",
        "first_name": "KIMBERLY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP10682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

• Shawna Rae Ward, CRNP
• Steven George Ward, DO
• Taylor Ward
• Timothy D Ward, M.D.
• Casey Dawn Warden Dutton
• Wardzala & Associates, MD, PA
• Lawrence Joseph Wardzala, M.D.
• Jean Marie Ware
• Noah Ware, DPT
• Jessica Lily Warffuel, MD

All providers in Tucson, AZ · Speech-Language Pathologist in Arizona