Healthcare Provider Details

I. General information

NPI: 1275107559
Provider Name (Legal Business Name): NAOMI SCARLETT RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

5554 E ALDER AVE
MESA AZ
85206-1410
US

V. Phone/Fax

Practice location:
  • Phone: 480-564-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279S1500X
TaxonomySNF/Subacute Care Registered Respiratory Therapist
License Number0008338
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: