Healthcare Provider Details
I. General information
NPI: 1518884022
Provider Name (Legal Business Name): VALLEY PREMIERE MEDICAL ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6766 W GLENDALE AVE STE 105
GLENDALE AZ
85303-2694
US
IV. Provider business mailing address
6766 W GLENDALE AVE STE 105
GLENDALE AZ
85303-2694
US
V. Phone/Fax
- Phone: 623-248-1464
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARILENA
ORIEUKWU
Title or Position: OWNER, NURSE PRACTITIONER
Credential: NP
Phone: 623-248-1464