Healthcare Provider Details

I. General information

NPI: 1568160653
Provider Name (Legal Business Name): HELEN MARIE MCGLASHEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 05/18/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 N 20TH ST UNIT 209
PHOENIX AZ
85016-5485
US

IV. Provider business mailing address

4201 N 20TH ST UNIT 209
PHOENIX AZ
85016-5485
US

V. Phone/Fax

Practice location:
  • Phone: 208-315-4096
  • Fax:
Mailing address:
  • Phone: 208-315-4096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number291061
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN209609
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: