Healthcare Provider Details
I. General information
NPI: 1265298368
Provider Name (Legal Business Name): INTEGRATED CLINICAL HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1530 E WILLIAMS FIELD RD STE 201
GILBERT AZ
85295-1825
US
IV. Provider business mailing address
1530 E WILLIAMS FIELD RD STE 201
GILBERT AZ
85295-1825
US
V. Phone/Fax
- Phone: 520-510-5825
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAMDA
AWAAL
Title or Position: OWNER NP
Credential:
Phone: 623-633-5285