NPI Code Details Logo

NPI 1083406722

NPI 1083406722 : ALLIANCE WOUND CARE SERVICES PLLC : SURPRISE, AZ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1083406722
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ALLIANCE WOUND CARE SERVICES PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/19/2025
-----------------------------------------------------
    Last Update Date     |    01/28/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    17316 N KIMBERLY WAY 
-----------------------------------------------------
    City                 |    SURPRISE
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85374-9686
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    575-491-5367
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4 DOMINION DRIVE BLDG 4, STE 100
-----------------------------------------------------
    City                 |    SAN ANTONIO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    78257
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    210-850-5790
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     BRENDA LEA BAKER 
-----------------------------------------------------
    Credential           |    FNP-BC
-----------------------------------------------------
    Telephone            |    888-706-1444
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.