Healthcare Provider Details

I. General information

NPI: 1932664323
Provider Name (Legal Business Name): LUXE WOMEN'S HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2019
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21321 E OCOTILLO RD STE 126
QUEEN CREEK AZ
85142-5995
US

IV. Provider business mailing address

22424 S ELLSWORTH LOOP RD UNIT 1007
QUEEN CREEK AZ
85142-7124
US

V. Phone/Fax

Practice location:
  • Phone: 480-550-5117
  • Fax: 833-424-7117
Mailing address:
  • Phone: 480-550-5117
  • Fax: 833-424-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER WRIGHT-BENNION
Title or Position: OWNER/PROVIDER
Credential: MSN, CNS, APRN
Phone: 480-550-5117