Nicole Elizabeth Klunk, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

271552 Issued in AZ

Practice address

14823 W Bell Rd Ste 208
Surprise, AZ 85374-7613

Phone

(623) 225-7030

NPI assigned

Nov 1, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Arizona Kids Pediatrics LTD

  • Primary Care Clinic/Center
  • Surprise, AZ
  • NPI 1609311109
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1366042988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21751 N 86TH LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822497",
            "telephone_number": "928-592-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14823 W BELL RD STE 208",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747613",
            "telephone_number": "623-225-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUNK",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN211157",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "271552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisean Jordan Kirk
• Sidney Ray Kirkeby
• Wyatt Richard Kissling, DC
• KJ Nutrition
• Michael Floyd Kleven, DO
• KMS Solutions, LLC
• Tina M Knezevic, PAC
• Karli Jo Knight, COTA/L
• James Ryan Knori
• Anna Theresa Koester, FNP-BC

• Pediatric Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.