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General NPI Number Information
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NPI Number | 1174599013
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Entity Type | Individual
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Provider Name | AMY SUZANNE CHURCHILL FNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5425 EAST BELL RD. 145
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone | 602-354-3172
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Fax | 602-354-3173
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Provider Business Mailing Address
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Address Line | 5425 EAST BELL ROAD 145
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City | SCOTTSDALE
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State | AZ
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Zip | 85254
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Country | US
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Telephone | 602-354-3172
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Fax | 602-354-3173
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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 | AP1299
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License Number State | AZ
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