MEDICARE: ROSA LUZ HELM LPN

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	164W00000X	Licensed Practical Nurse	044583	AZ

General Provider Information

NPI Number	:	1134736291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA LUZ HELM LPN

Provider Business Mailing Address
First Line	:	6921 S 220TH AVE
Second Line	:
City	:	BUCKEYE
State	:	AZ
Zip	:	85326-9208
Country	:	US
Telephone Number	:	623-341-7474
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 S 67TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-6523
Country	:	US
Telephone Number	:	623-474-7705
Fax Number	:

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

Provider Enumeration Date	:	09/23/2020
Last Update Date	:	09/23/2020

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Directions to “ ROSA LUZ HELM LPN” Practice Location

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