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

Kristin Landavazo

Individual provider Family Nurse Practitioner · NPI 1598420846

Kristin Landavazo is a Nurse Practitioner in Glendale, Arizona. Qualified in 2021, 5 years ago. Practices with Athena Medical Group, a 43-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
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Practice location Address checks out

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone: (602) 865-5555
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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 F09210833 (AZ)

Record details

NPI number1598420846
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 2, 2021
Last updated in NPPESNovember 2, 2021
Certification dateNovember 2, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Athena Medical Group — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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