Most Relevant Information
Provider Data
| NPI Number: | 1003681438 |
| Provider Name: | KIRSTYNN VANDERVELDE |
| Entity Type: | Individual |
| Taxonomy Code: | 246Q00000X |
| Specialty: | Specialist/Technologist, Pathology |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/15/2023 |
| Last Updated: | 11/15/2023 |
Provider Practice Location
1810 N LAUREL AVE
PHOENIX
AZ
850071629
Practice Location Phone/Fax
| Phone: | 6614886195 |
| Fax: |
Provider Mailing Location
1810 N LAUREL AVE
PHOENIX
AZ
850071629
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |