Active NPI
Kimberly D Vana, FNP
- Family Nurse Practitioner
- Glendale, AZ
National Provider Identifier
1407947104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN036510
- Practice address
- 6320 W Union Hills Drive
BLDG B Suite 1000
Glendale, AZ 85308-1096 - Phone
- (623) 328-5908
- Fax
- (480) 830-3901
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN036510 | AZ | Primary |
Addresses
Primary practice location
6320 W Union Hills Drive
BLDG B Suite 1000
Glendale, AZ 85308-1096
Mailing address
6320 W Union Hills Drive
BLDG B Suite 1000
Glendale, AZ 85308-1096
Phone (623) 328-5908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 720643 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona State University | Past | Accepting new patients | |
| Privia Medical Group Arizona, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520553600000",
"number": "1407947104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6320 W UNION HILLS DRIVE",
"address_2": "BLDG B SUITE 1000",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081096",
"telephone_number": "623-328-5908",
"fax_number": "480-830-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 W UNION HILLS DRIVE",
"address_2": "BLDG B SUITE 1000",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081096",
"telephone_number": "623-328-5908",
"fax_number": "480-830-3901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANA",
"first_name": "KIMBERLY",
"middle_name": "D",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2018-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "RN036510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "720643",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.