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General NPI Number Information
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NPI Number | 1104692870
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Entity Type | Organization
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Legal Business Name | HEALINGFX LLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 03/02/2024
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Provider Practice Location Address
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Address Line | 12129 W REMUDA DR
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City | PEORIA
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State | AZ
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Zip | 85383-5864
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Country | US
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Telephone | 480-980-7309
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Fax |
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Provider Business Mailing Address
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Address Line | 12129 W REMUDA DR
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City | PEORIA
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State | AZ
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Zip | 85383-5864
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Country | US
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Telephone | 480-980-7309
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | WILLIAM OHARA
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Credential | PMHNP
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Telephone | 480-980-7309
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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 |
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License Number State |
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