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NPI 1467173906

NPI 1467173906 : ESSENCE OF HEALING PRIMARY CARE : MESA, AZ

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General NPI Number Information
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    NPI Number           |    1467173906
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    Entity Type          |    Organization 
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    Legal Business Name  |    ESSENCE OF HEALING PRIMARY CARE 
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Dates
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    Enumeration Date     |    09/02/2022
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    Last Update Date     |    09/02/2022
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Provider Practice Location Address
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    Address Line         |    855 E BROWN RD STE 10 
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    City                 |    MESA
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    State                |    AZ
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    Zip                  |    85203-4949
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    Country              |    US
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    Telephone            |    623-910-3171
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    Fax                  |    949-655-2754
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Provider Business Mailing Address
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    Address Line         |    6334 E VIEWMONT DR UNIT 7 
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    City                 |    MESA
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    State                |    AZ
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    Zip                  |    85215-7781
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    Country              |    US
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    Telephone            |    602-810-9109
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/PROVIDER
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    Name                 |     KATHY  NAFISI 
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    Credential           |    FNP-C
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    Telephone            |    602-810-9109
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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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