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General NPI Number Information
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NPI Number | 1194257758
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Entity Type | Individual
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Provider Name | ANGELA L BAZEMORE QUAYE DBH, CFNC, RDMS, SAP
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Gender | Female
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 29697 N 69TH DR
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City | PEORIA
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State | AZ
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Zip | 85383-3178
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Country | US
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Telephone | 443-636-0686
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Fax | 602-532-7857
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Provider Business Mailing Address
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Address Line | 29697 N 69TH DR
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City | PEORIA
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State | AZ
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Zip | 85383-3178
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Country | US
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Telephone | 443-636-0686
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Fax | 602-532-7857
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 108395
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License Number State | MD
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