Healthcare Provider Details

I. General information

NPI: 1609464163
Provider Name (Legal Business Name): NEW BEGINNINGS SCHOOL OF NURSING ASSISTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2021
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17223 N CAVE CREEK RD UNIT 9
PHOENIX AZ
85032-2481
US

IV. Provider business mailing address

17223 N CAVE CREEK RD UNIT 9
PHOENIX AZ
85032-2481
US

V. Phone/Fax

Practice location:
  • Phone: 480-738-3221
  • Fax:
Mailing address:
  • Phone: 480-738-3221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MISS RENAE TYLYNNE MITCHELL
Title or Position: CEO
Credential: MSN, APRN, FNP-C
Phone: 480-738-3221