Provider Demographics
NPI:1871975482
Name:KASNOT, JACQUELINE (DNP)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:KASNOT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 E GREENWAY PKWY
Mailing Address - Street 2:#100A
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2073
Mailing Address - Country:US
Mailing Address - Phone:480-348-3200
Mailing Address - Fax:
Practice Address - Street 1:4712 E DYNAMITE BLVD # 100A
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-6243
Practice Address - Country:US
Practice Address - Phone:480-342-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7875363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health