Healthcare Provider Details

I. General information

NPI: 1962405480
Provider Name (Legal Business Name): GEORGETTE C VODHI ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GEORGETTE C THOMAS NP

II. Dates (important events)

Enumeration Date: 05/30/2005
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

V. Phone/Fax

Practice location:
  • Phone: 877-506-3627
  • Fax: 877-506-4560
Mailing address:
  • Phone: 877-506-3627
  • Fax: 877-506-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number201050011NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: