Individual provider Active NPI

Kristin Leigh Church, APRN, FNP-C

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1578439113
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F12250240 Issued in AZ
Practice address
4409 W Gelding Dr
Glendale, AZ 85306-4526
Phone
(480) 433-3862
NPI assigned
Oct 13, 2025
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 258783 AZ
Family Nurse Practitioner 363LF0000X F12250240 AZ Primary

Addresses

Primary practice location

4409 W Gelding Dr
Glendale, AZ 85306-4526

Mailing address

4409 W Gelding Dr
Glendale, AZ 85306-4526
Phone (480) 433-3862

Other practice location 1

11022 N 28th Dr Ste 270
Phoenix, AZ 85029-5639
Phone (623) 404-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219000935 AZ Practitioner - Nurse Practitioner 1850871682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wings of Hope Medical Services LLCGroup PAC ID 7719277169, 8 clinicians

Practice addresses (Care Compare)

11022 N 28TH Dr
Suite 270
Phoenix, AZ 85029-5639
Phone (602) 971-0304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
258783AZMDRegistered Nurse
F12250240AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wings of Hope Medical Services, LLC CurrentSince Feb 1, 2026 Accepting new patients
Bloomcare PLLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

11022 N 28th Dr
Ste 270
Phoenix, AZ 85029
Phone (602) 971-0304

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1578439113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 W GELDING DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064526",
            "telephone_number": "480-433-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 W GELDING DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064526",
            "telephone_number": "480-433-3862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11022 N 28th Dr Ste 270",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850295639",
            "country_code": "US",
            "telephone_number": "623-404-8505",
            "fax_number": "602-429-8475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "KRISTIN",
        "middle_name": "LEIGH",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-13",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "258783",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "F12250240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.