Healthcare Provider Details

I. General information

NPI: 1376551978
Provider Name (Legal Business Name): ENDURO MEDICAL ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3541 ENDURO DR
LAKE HAVASU CITY AZ
86404-2255
US

IV. Provider business mailing address

3541 ENDURO DR
LAKE HAVASU CITY AZ
86404-2255
US

V. Phone/Fax

Practice location:
  • Phone: 928-854-2806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP2374
License Number StateAZ

VIII. Authorized Official

Name: NATASCHA E. TROEHLER
Title or Position: NURSE PRACTITIONER/OWNER
Credential: ANP-C
Phone: 928-854-2806