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General NPI Number Information
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NPI Number | 1487045795
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Entity Type | Individual
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Provider Name | AMORY GODWIN CARINGAL GRIJALDO AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5499
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 12451 W GENTLE RAIN RD
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City | PEORIA
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State | AZ
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Zip | 85383-7198
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Country | US
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Telephone | 623-256-6994
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Fax | 623-256-6994
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 73268
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP7637
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP7637
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License Number State | AZ
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