Healthcare Provider Details

I. General information

NPI: 1477305134
Provider Name (Legal Business Name): ABIGAIL C MENDEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST STE 4035
PHOENIX AZ
85020-2434
US

IV. Provider business mailing address

3260 N HAYDEN RD STE 112
SCOTTSDALE AZ
85251-6650
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-3575
  • Fax: 602-279-2666
Mailing address:
  • Phone: 602-264-9100
  • Fax: 602-264-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number305742
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: