Provider Demographics
NPI:1053037812
Name:KAISER, MICHEAL ANTHONY (APRN-RNP)
Entity type:Individual
Prefix:
First Name:MICHEAL
Middle Name:ANTHONY
Last Name:KAISER
Suffix:
Gender:M
Credentials:APRN-RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2038
Mailing Address - Country:US
Mailing Address - Phone:520-224-4706
Mailing Address - Fax:
Practice Address - Street 1:302 EL CAMINO REAL STE 11A
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2825
Practice Address - Country:US
Practice Address - Phone:520-255-5475
Practice Address - Fax:855-801-7998
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ281987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily