Healthcare Provider Details

I. General information

NPI: 1639382237
Provider Name (Legal Business Name): HEALTHY LOOKS FOR WOMEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 03/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6206 W BELL RD SUITE 1
GLENDALE AZ
85308-3750
US

IV. Provider business mailing address

6206 W BELL RD SUITE 1
GLENDALE AZ
85308-3750
US

V. Phone/Fax

Practice location:
  • Phone: 602-547-1600
  • Fax: 602-547-1622
Mailing address:
  • Phone: 602-547-1600
  • Fax: 602-547-1622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN041756
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN041507
License Number StateAZ

VIII. Authorized Official

Name: SINDY L. SHELDON
Title or Position: CO-OWNER
Credential: NP
Phone: 602-547-1600