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General NPI Number Information
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NPI Number | 1306267166
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Entity Type | Organization
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Legal Business Name | ROBERT L GAUNT, FNP-BC LLC
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Dates
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Enumeration Date | 12/21/2013
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Last Update Date | 12/21/2013
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Provider Practice Location Address
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Address Line | 111 W 6TH ST UNIT 607
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City | TEMPE
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State | AZ
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Zip | 85281-3991
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Country | US
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Telephone | 480-398-7795
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Fax | 480-269-8505
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Provider Business Mailing Address
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Address Line | 111 W 6TH ST UNIT 607
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City | TEMPE
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State | AZ
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Zip | 85281-3991
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Country | US
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Telephone | 480-398-7795
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Fax | 480-269-8505
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT LLOYD GAUNT
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Credential | FNP-C
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Telephone | 480-398-7795
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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 | AP4759
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License Number State | AZ
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