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General NPI Number Information
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NPI Number | 1295403848
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Entity Type | Individual
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Provider Name | ELLE R CORONEL
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 4304 E CAMPBELL AVE APT 1059
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City | PHOENIX
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State | AZ
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Zip | 85018-3780
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Country | US
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Telephone | 602-503-7231
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Fax |
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Provider Business Mailing Address
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Address Line | 1953 E LAGUNA DR
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City | TEMPE
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State | AZ
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Zip | 85282-5912
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Country | US
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Telephone | 602-503-7231
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 335720
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN212513
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License Number State | AZ
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