Healthcare Provider Details

I. General information

NPI: 1669632360
Provider Name (Legal Business Name): DEBBIE KAY MCGONIGLE W.H.C.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18555 N 79TH AVE SUITE E-101
GLENDALE AZ
85308-8370
US

IV. Provider business mailing address

18555 N 79TH AVE SUITE E-101
GLENDALE AZ
85308-8370
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-3100
  • Fax: 623-334-9125
Mailing address:
  • Phone: 623-412-3100
  • Fax: 623-334-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN041460
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: