Healthcare Provider Details

I. General information

NPI: 1942011309
Provider Name (Legal Business Name): MICHELE PARDON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 E VIA LINDA
SCOTTSDALE AZ
85258-5314
US

IV. Provider business mailing address

4148 E KROLL DR
GILBERT AZ
85234-7521
US

V. Phone/Fax

Practice location:
  • Phone: 480-312-6340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number227832
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: