Healthcare Provider Details

I. General information

NPI: 1548749690
Provider Name (Legal Business Name): ANNE ELIZABETH PUGGINI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE ELIZABETH GATZ

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 478
PHOENIX AZ
85037
US

IV. Provider business mailing address

9305 W THOMAS RD STE 478
PHOENIX AZ
85037-3375
US

V. Phone/Fax

Practice location:
  • Phone: 632-236-8507
  • Fax:
Mailing address:
  • Phone: 632-236-8507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN179986
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11627
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: