JACQUELINE KIENHOLZ (NPI# 1649618356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649618356 |
| Entity Type | Individual |
| Full Name | JACQUELINE KIENHOLZ |
| Other Name | JACQUELINE GREEN |
| Credential | PA |
| Practice Address |
Banner Md Anderson Cancer Center 2946 E. Banner Gateway Drive Gilbert AZ 85234 |
| Mailing Address |
Banner Md Anderson Cancer Center 2940 E. Banner Gateway Drive Gilbert AZ 85234 |
| Practice Telephone | 4802566444 |
| Practice Fax Number | 4802563682 |
| Mailing Telephone | 4802566444 |
| Mailing Fax Number | 4802563682 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
5467 | AZ | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA22903 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5467 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
PA22903 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
BANNER MD ANDERSON CANCER CENTER 2946 E. BANNER GATEWAY DRIVE |
| City | GILBERT |
| State | AZ |
| Zip Code | 85234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689657025 | William Carmen Cirocco | Colon & Rectal Surgery | Banner Md Anderson Cancer Center, 2940 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2005-11-21 |
| 1629544259 | Whitney Layton | Physician Assistant | Banner Md Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ 85234 | 2018-10-22 |
| 1275030264 | Richelle B Miller | Registered Nurse | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2018-04-06 |
| 1073051983 | Tessa Louise Meyer | Nurse Practitioner | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2017-02-10 |
| 1558818211 | Clair Watkins | Surgery | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2016-09-09 |
| 1194181370 | Ma Janice Lalitha A Desiongco | Nurse Practitioner | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2016-01-04 |
| 1447621982 | Rachael Yasuda | Physician Assistant | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2015-10-09 |
| 1689058992 | Francis Rahul Luciano | Physician Assistant | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2015-07-16 |
| 1104230333 | Sarah E Nicholas | Radiology | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2014-06-16 |
| 1962848275 | Chad R Burk | Radiology | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2013-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| 1073152070 | American Care Concepts Hospice LLC | Hospice Care, Community Based | 765 N. Lindsay Rd., Ste. 208, Gilbert, AZ 85234 | 2019-12-23 |
| 1457918864 | Intuitive Healing Counseling Services, Pllc | Counselor | 3303 E Baseline Rd, Building 5, Suite 109, Gilbert, AZ 85234 | 2019-05-21 |
| 1487123907 | San Tan Behavioral Health Services LLC | Respite Care | 2671 East Vermont Court, Gilbert, AZ 85234 | 2018-11-14 |
| 1770052292 | San Tan Behavioral Health Services | Respite Care | 3970 East Juanita Avenue, Gilbert, AZ 85234 | 2018-11-14 |
| 1891262887 | Victoria Elizabeth Klennertt | Behavior Technician | 3503 E Michelle Way, Gilbert, AZ 85234 | 2018-10-27 |
| 1225503634 | Julia Elizabeth Wiens | Social Worker | 3651 E Baseline Rd Ste 120, Gilbert, AZ 85234 | 2018-10-11 |
| 1295219798 | Raylene Dawn Cargiulo | Registered Nurse | 55 S. Greenfield Rd., Gilbert, AZ 85234 | 2018-09-20 |
| 1346729092 | Katherine M Winegar | Nurse Practitioner | Banner Md Anderson Cancer Center- Administration Office, 2940 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-08-13 |
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| Find all providers in zip 85234 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104145325 | Rajesh Ramanathan | Surgery | Banner Md Anderson Cancer Center, 2946 E. Banner Gateway Drive, Gilbert, AZ 85234 | 2010-05-27 |
| 1235324518 | Mark Gimbel | Surgery | 2946 E Banner Gateway Dr, Gilbert, AZ 85234-2165 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972805240 | James Garvey Hopkins | Surgery | 1035 N Vista Verde, Litchfield Park, AZ 85340-4501 | 2010-11-18 |
| 1487881710 | Zeynep Bostanci | Surgery | 925 E. Mcdowell Rd., Phoenix, AZ 85006 | 2009-06-12 |
| 1902049414 | Vasilena Zheleva | Surgery | 14200 West Celebrate Life Way, Cancer Treatment Centers of America, Goodyear, AZ 85338 | 2009-04-14 |
| 1992903413 | Carl E Silver | Surgery | 10085 N 135th Pl, Scottsdale, AZ 85259-5420 | 2007-07-05 |
| 1801908181 | Grace Hou | Surgery | 6320 N Lacholla Blvd, Suite 340, Tucson, AZ 85741 | 2006-08-31 |
| 1063421766 | Ronald Scott Chamberlain | Surgery | 2122 E Highland Ave Ste 100, Phoenix, AZ 85016-4740 | 2006-08-05 |
| 1003855214 | Michele Lynn Boyce Ley | Surgery | 2625 N Craycroft Rd Ste 201, Tucson, AZ 85712-2268 | 2006-06-05 |
| 1427538149 | Valley Emergency Surgical Services Plc | Surgery | 963 N Mcqueen Rd, Chandler, AZ 85225-8149 | 2018-08-21 |
| 1629359591 | Emily T Ho | Surgery | 6111 E Arbor Ave, Mesa, AZ 85206-6059 | 2011-09-06 |
| 1639464829 | Sarwat Ahmad | Surgery | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2011-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.