Healthcare Provider Details

I. General information

NPI: 1578441481
Provider Name (Legal Business Name): VERONICA BRAVO RAMIREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3232 N 20TH ST UNIT 104
PHOENIX AZ
85016-7268
US

IV. Provider business mailing address

3232 N 20TH ST UNIT 104
PHOENIX AZ
85016-7268
US

V. Phone/Fax

Practice location:
  • Phone: 602-483-9787
  • Fax:
Mailing address:
  • Phone: 602-483-9787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number310364
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code364SL0600X
TaxonomyLong-Term Care Clinical Nurse Specialist
License Number310364
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number310364
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number310364
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: