Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KIMBERLY TAN SUPNET NP
NPI 1417720152
Nurse Practitioner in Scottsdale, AZ

Q: What is Kimberly Supnet's NPI number?

The NPI number for Kimberly Supnet is 1417720152. It was assigned to this individual provider in the NPPES registry on November 3, 2023.

Q: What is Kimberly Supnet's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Supnet was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2023

13400 E SHEA BLVD, SCOTTSDALE, AZ 85259(480) 301-8000 Get Directions Write a Review

NPPES record last updated: September 22, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 22, 2026, Nov 3, 2023 (2 updates tracked since 2023).

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About Kimberly Tan Supnet Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY TAN SUPNET NP (NPI 1417720152) is an individual nurse practitioner in Scottsdale, Arizona, licensed in Arizona (341773) and active in the NPI registry since November 2023.

NPPES Registry Identity

NPI1417720152

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKIMBERLY TAN SUPNETCredential: NP

Location Address13400 E SHEA BLVDScottsdale, AZ 85259-5404

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912

Phone(480) 301-8000

Sole ProprietorNo

Enumeration DateNovember 3, 2023

Last NPPES UpdateSeptember 22, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 22, 2026

✔ NPI 1417720152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in AZ · 341773

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License APRN-4271 (HI)

13400 E SHEA BLVD, Scottsdale, AZ 85259

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMITKUMAR MEHTA MD

Internal Medicine (Hematology & Oncology)