Healthcare Provider Details

I. General information

NPI: 1750968954
Provider Name (Legal Business Name): AMY BINEGAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 E MCDOWELL RD STE A
PHOENIX AZ
85006-2603
US

IV. Provider business mailing address

7330 N 16TH ST STE B101
PHOENIX AZ
85020-5274
US

V. Phone/Fax

Practice location:
  • Phone: 602-358-8588
  • Fax:
Mailing address:
  • Phone: 602-358-8588
  • Fax: 602-688-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number63165
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number275034
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: