Individual provider Active NPI

Kyle Ann Graber, RN

  • Plastic Surgery Registered Nurse
  • Mesa, AZ
National Provider Identifier
1679056386
Registry record updated Sep 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Registered NurseTaxonomy code 163WS0121X
License
RN083020 Issued in AZ
Practice address
2204 S Dobson Rd Ste 205
Mesa, AZ 85202-6457
Phone
(480) 494-5173
NPI assigned
Sep 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Registered Nurse 163WS0121X RN083020 AZ Primary

Addresses

Primary practice location

2204 S Dobson Rd Ste 205
Mesa, AZ 85202-6457

Mailing address

2160 E Prescott PL
Chandler, AZ 85249-2994
Phone (602) 999-6955

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN083020AZMDPlastic Surgery Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536451200000",
    "number": "1679056386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 E PRESCOTT PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852492994",
            "telephone_number": "602-999-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 S DOBSON RD STE 205",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026457",
            "telephone_number": "480-494-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "KYLE",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2018-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0121X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Plastic Surgery",
            "state": "AZ",
            "license": "RN083020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.

Verify at the official NPI Registry.