Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberley Sue Fahle

Individual provider Family Nurse Practitioner · NPI 1356052161

Kimberley Sue Fahle is a Nurse Practitioner in Tucson, Arizona. Qualified in 2022, 4 years ago. Practices with Full Spectrum Wellness Inc, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
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Practice location Address checks out

2675 N Wyatt Dr
Tucson, AZ 85712-6107
Phone: (937) 935-7461
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 279734 (AZ)

Record details

NPI number1356052161
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 13, 2022
Last updated in NPPESDecember 13, 2022
Certification dateDecember 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Full Spectrum Wellness Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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