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General NPI Number Information
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NPI Number | 1083089460
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Entity Type | Organization
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Legal Business Name | WHITE GLOVE HEALTH
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Dates
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Enumeration Date | 12/10/2015
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 2906 S LYNCH CR
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City | MESA
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State | AZ
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Zip | 85212
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Country | US
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Telephone | 877-217-4436
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Fax |
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Provider Business Mailing Address
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Address Line | 2906 S LYNCH CIR
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City | MESA
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State | AZ
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Zip | 85212-1567
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS RELATIONS
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Name | SARAH HOPE
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Credential |
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Telephone | 877-217-4536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP8072
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License Number State | AZ
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