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General NPI Number Information
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NPI Number | 1174485858
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Entity Type | Organization
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Legal Business Name | IRONWOOD LEGACY HEALTH LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 13100 S SUNLAND GIN RD STE 2
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City | ARIZONA CITY
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State | AZ
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Zip | 85123-8659
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Country | US
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Telephone | 520-468-2238
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Fax | 520-844-1307
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Provider Business Mailing Address
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Address Line | 1664 E FLORENCE BLVD STE 4
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4779
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Country | US
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Telephone | 520-468-2238
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Fax | 520-844-1307
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELISA A HARPER
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Credential | FNP-C
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Telephone | 520-468-2238
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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 |
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License Number State |
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