Healthcare Provider Details

I. General information

NPI: 1619782539
Provider Name (Legal Business Name): NAOMI NOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9897 W MCDOWELL RD STE 320
TOLLESON AZ
85353-1625
US

IV. Provider business mailing address

2545 W FRYE RD STE 5
CHANDLER AZ
85224-6273
US

V. Phone/Fax

Practice location:
  • Phone: 480-821-3601
  • Fax:
Mailing address:
  • Phone: 480-821-3600
  • Fax: 480-345-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number331613
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: