Healthcare Provider Details

I. General information

NPI: 1669068995
Provider Name (Legal Business Name): ALAN GARCIA APRN-RNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 N 15TH AVE FL 3
PHOENIX AZ
85015-3328
US

IV. Provider business mailing address

5040 N 15TH AVE FL 3
PHOENIX AZ
85015-3328
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax: 602-200-6004
Mailing address:
  • Phone: 602-277-5551
  • Fax: 602-200-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number250409
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: