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General NPI Number Information
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NPI Number | 1285402040
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Entity Type | Organization
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Legal Business Name | ELEVATE MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 2815 S ALMA SCHOOL RD STE 112
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City | MESA
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State | AZ
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Zip | 85210-4046
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Country | US
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Telephone | 480-506-9701
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Fax | 877-481-1550
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Provider Business Mailing Address
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Address Line | 2815 S ALMA SCHOOL RD STE 112
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City | MESA
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State | AZ
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Zip | 85210-4046
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Country | US
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Telephone | 480-506-9701
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Fax | 877-481-1550
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY DAWN LEE
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Credential | FNP-C
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Telephone | 602-412-7677
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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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