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General NPI Number Information
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NPI Number | 1134651276
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Entity Type | Individual
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Provider Name | MARKETTA TOLIVER DNP, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 13471 W CORNERSTONE BLVD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2713
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Country | US
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Telephone | 480-964-2273
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Fax | 623-213-8808
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Provider Business Mailing Address
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Address Line | 3033 N CENTRAL AVE STE 145
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City | PHOENIX
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State | AZ
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Zip | 85012-2808
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Country | US
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Telephone | 480-964-2273
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Fax | 623-974-6721
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A005111
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 296931
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License Number State | AZ
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