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General NPI Number Information
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NPI Number | 1376847111
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Entity Type | Individual
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Provider Name | ANTONETTE MARIE MARANDO FNP-BC, MSN
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Gender | Female
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 3210 E UNION HILLS DR
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City | PHOENIX
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State | AZ
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Zip | 85050-3223
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Country | US
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Telephone | 602-788-4794
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Fax |
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Provider Business Mailing Address
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Address Line | 4231 E CASCALOTE DR
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City | CAVE CREEK
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State | AZ
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Zip | 85331-3862
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Country | US
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Telephone | 480-322-9735
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP2748
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License Number State | AZ
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