Healthcare Provider Details

I. General information

NPI: 1295571214
Provider Name (Legal Business Name): DEBORAH BERNADINE CENA ARTUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N 12TH ST FL 2
PHOENIX AZ
85006-2837
US

IV. Provider business mailing address

10417 W FOOTHILL DR
PEORIA AZ
85383-2648
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-5180
  • Fax:
Mailing address:
  • Phone: 480-249-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10529
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: