Healthcare Provider Details

I. General information

NPI: 1851840870
Provider Name (Legal Business Name): ANITA PALANDRI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2016
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 W ROSE GARDEN LN STE 110
PHOENIX AZ
85027-3135
US

IV. Provider business mailing address

4048 W ALEX LOOP
PHOENIX AZ
85083-2444
US

V. Phone/Fax

Practice location:
  • Phone: 623-265-7215
  • Fax: 833-465-1462
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9006
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP9006
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: