Healthcare Provider Details

I. General information

NPI: 1437709573
Provider Name (Legal Business Name): MARGARET EILEEN VAN LIEW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16390 N 59TH AVE STE 200
GLENDALE AZ
85306-1711
US

IV. Provider business mailing address

13430 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85254-4058
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number232196
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: