Healthcare Provider Details

I. General information

NPI: 1720381163
Provider Name (Legal Business Name): ALINA STANCA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 08/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12428 W THUNDERBIRD RD EL MIRAGE FAMILY HEALTH CENTER
EL MIRAGE AZ
85335-3113
US

IV. Provider business mailing address

2929 E THOMAS RD
PHOENIX AZ
85016-8034
US

V. Phone/Fax

Practice location:
  • Phone: 623-344-6500
  • Fax: 623-344-6501
Mailing address:
  • Phone: 602-470-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number109734
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: