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General NPI Number Information
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NPI Number | 1316867047
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Entity Type | Individual
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Provider Name | IVY MICHEL
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Gender | Female
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 4435 E CHANDLER BLVD STE 200
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City | PHOENIX
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State | AZ
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Zip | 85048-7651
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Country | US
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Telephone | 602-491-1997
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Fax |
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Provider Business Mailing Address
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Address Line | 3318 W KRALL ST
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City | PHOENIX
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State | AZ
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Zip | 85017-1435
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Country | US
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Telephone | 623-556-6587
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 256008
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License Number State | AZ
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