Healthcare Provider Details

I. General information

NPI: 1093452427
Provider Name (Legal Business Name): ALEJANDRA BERARDINELLI PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 S DOBSON RD STE 301
MESA AZ
85202-4773
US

IV. Provider business mailing address

8407 E BONNIE ROSE AVE
SCOTTSDALE AZ
85250-6715
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-7409
  • Fax: 480-412-7202
Mailing address:
  • Phone: 915-787-0461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number314469
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number903010
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1084065
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP61444941
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number314469
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: