Healthcare Provider Details

I. General information

NPI: 1114341237
Provider Name (Legal Business Name): A2Z HOUSECALLS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20624 N CAVE CREEK RD SUITE 140
PHOENIX AZ
85024-4453
US

IV. Provider business mailing address

PO BOX 10377
PHOENIX AZ
85064-0377
US

V. Phone/Fax

Practice location:
  • Phone: 480-347-0310
  • Fax: 480-365-0209
Mailing address:
  • Phone: 480-347-0310
  • Fax: 480-365-0209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP0322
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4859
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0513130
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP2677
License Number StateAZ

VIII. Authorized Official

Name: JEANNETTE MARTINEZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 480-347-0310