Healthcare Provider Details

I. General information

NPI: 1013836048
Provider Name (Legal Business Name): NINA PALERMO MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 W WIND CAVE DR
SAN TAN VALLEY AZ
85140-7296
US

IV. Provider business mailing address

678 W WIND CAVE DR
SAN TAN VALLEY AZ
85140-7296
US

V. Phone/Fax

Practice location:
  • Phone: 480-307-4477
  • Fax:
Mailing address:
  • Phone: 480-307-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number246581
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: