Healthcare Provider Details

I. General information

NPI: 1316424732
Provider Name (Legal Business Name): ANGELA CAMMARATA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 E UNIVERSITY DR STE 150
PHOENIX AZ
85034-7423
US

IV. Provider business mailing address

2983 OLD LAGUARDO RD E
LEBANON TN
37087-8965
US

V. Phone/Fax

Practice location:
  • Phone: 480-493-3444
  • Fax: 720-598-0440
Mailing address:
  • Phone: 615-525-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number24460
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24460
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: