Healthcare Provider Details

I. General information

NPI: 1073440673
Provider Name (Legal Business Name): TELEDNPNOW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2923 N HAWTHORN DR
FLORENCE AZ
85132-6872
US

IV. Provider business mailing address

2923 N HAWTHORN DR
FLORENCE AZ
85132-6872
US

V. Phone/Fax

Practice location:
  • Phone: 480-200-6897
  • Fax: 480-781-4981
Mailing address:
  • Phone: 480-200-6897
  • Fax: 480-781-4981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHINY JOB
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 480-200-6897