Healthcare Provider Details

I. General information

NPI: 1972370955
Provider Name (Legal Business Name): RANI NOBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2023
Last Update Date: 11/23/2024
Certification Date: 11/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 W ASPERA BLVD
GLENDALE AZ
85308-7947
US

IV. Provider business mailing address

7701 W ASPERA BLVD
GLENDALE AZ
85308-7947
US

V. Phone/Fax

Practice location:
  • Phone: 623-248-2100
  • Fax:
Mailing address:
  • Phone: 602-312-9837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10645
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: