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NPI Code Detail

MEDICARE: MRS. JANELLE CHRISTINE RASTAD FNP

MEDICARE: MRS. JANELLE CHRISTINE RASTAD FNP
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
1363LF0000XFamily Nurse PractitionerFNP16137CA
2363LF0000XFamily Nurse PractitionerAP2651AZ

General Provider Information

NPI Number : 1073622932
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANELLE CHRISTINE RASTAD FNP
Provider Business Mailing Address
First Line : 4430 E RAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-6092
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 4430 E RAY RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-6092
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 06/21/2013

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