Healthcare Provider Details

I. General information

NPI: 1124327911
Provider Name (Legal Business Name): NATUROPATHS INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N SAN FRANCISCO ST STE F
FLAGSTAFF AZ
86001-3260
US

IV. Provider business mailing address

1100 N SAN FRANCISCO ST STE F
FLAGSTAFF AZ
86001-3260
US

V. Phone/Fax

Practice location:
  • Phone: 928-214-8793
  • Fax: 928-214-0147
Mailing address:
  • Phone: 928-214-8793
  • Fax: 928-214-0147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number03-0715
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number07-1028
License Number StateAZ

VIII. Authorized Official

Name: BRANDIE E GOWEY
Title or Position: PRESIDENT
Credential: NMD
Phone: 928-214-7893