Healthcare Provider Details
I. General information
NPI: 1346274974
Provider Name (Legal Business Name): BRIAN D. AREY ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1144 E MCDOWELL RD #300
PHOENIX AZ
85006-2664
US
IV. Provider business mailing address
2929 E THOMAS RD
PHOENIX AZ
85016-8034
US
V. Phone/Fax
- Phone: 602-344-6550
- Fax: 602-344-6551
- Phone: 602-470-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | RN126953 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: