Healthcare Provider Details

I. General information

NPI: 1629291182
Provider Name (Legal Business Name): VINCETTA A CARROZZA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35707 N 33RD LN
PHOENIX AZ
85086-2289
US

IV. Provider business mailing address

35707 N 33RD LN
PHOENIX AZ
85086-2289
US

V. Phone/Fax

Practice location:
  • Phone: 623-445-7810
  • Fax: 623-445-7880
Mailing address:
  • Phone: 623-445-7810
  • Fax: 623-445-7880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN049161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: