Healthcare Provider Details

I. General information

NPI: 1063874956
Provider Name (Legal Business Name): BARBARA SCARCELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 N 3RD ST
PHOENIX AZ
85012-3031
US

IV. Provider business mailing address

25500 N NORTERRA DR
PHOENIX AZ
85085-8200
US

V. Phone/Fax

Practice location:
  • Phone: 602-282-9800
  • Fax:
Mailing address:
  • Phone: 623-277-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8558
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: