Healthcare Provider Details

I. General information

NPI: 1598601643
Provider Name (Legal Business Name): PRISCILLA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 E WHITTON AVE
PHOENIX AZ
85014-5051
US

IV. Provider business mailing address

1052 E WHITTON AVE
PHOENIX AZ
85014-5051
US

V. Phone/Fax

Practice location:
  • Phone: 480-765-1373
  • Fax:
Mailing address:
  • Phone: 480-765-1373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number335747
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: