MEDICARE: MERLE NUNEZ PALENCIA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN104810	AZ

General Provider Information

NPI Number	:	1023171840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERLE NUNEZ PALENCIA NP

Provider Business Mailing Address
First Line	:	9453 W TONOPAH DR
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-5342
Country	:	US
Telephone Number	:	623-825-2981
Fax Number	:

Provider Business Practice Location Address
First Line	:	3141 N 3RD AVE STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-4351
Country	:	US
Telephone Number	:	602-745-7943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/08/2007

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