Healthcare Provider Details

I. General information

NPI: 1235716341
Provider Name (Legal Business Name): NADINE APOSTU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13943 N 91ST AVE BLDG EP
PEORIA AZ
85381-3629
US

IV. Provider business mailing address

14642 W WETHERSFIELD RD
SURPRISE AZ
85379-5809
US

V. Phone/Fax

Practice location:
  • Phone: 480-963-1853
  • Fax:
Mailing address:
  • Phone: 903-422-9309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8085
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: