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General NPI Number Information
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NPI Number | 1164240347
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Entity Type | Organization
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Legal Business Name | AN NP FOR ME LLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 15048 W YOUNG ST
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City | SURPRISE
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State | AZ
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Zip | 85374-7484
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Country | US
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Telephone | 480-796-2730
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Fax |
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Provider Business Mailing Address
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Address Line | 13835 N TATUM BLVD STE 9120
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City | PHOENIX
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State | AZ
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Zip | 85032-5581
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Country | US
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Telephone | 480-381-5955
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ELISA E DEHERRERA
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Credential |
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Telephone | 480-381-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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