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General NPI Number Information
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NPI Number | 1518260645
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Entity Type | Organization
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Legal Business Name | VALLEY OF THE SUN PROFESSIONAL
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Dates
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Enumeration Date | 12/11/2010
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 19630 N WILLOW CREEK CIR
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City | SUN CITY
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State | AZ
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Zip | 85373-1234
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Country | US
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Telephone | 623-933-5991
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Fax | 623-933-5991
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Provider Business Mailing Address
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Address Line | 19630 N WILLOW CREEK CIR
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City | SUN CITY
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State | AZ
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Zip | 85373-1234
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Country | US
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Telephone | 623-933-5991
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Fax | 623-933-5991
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. MARIAN JOY REMINGTON
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Credential | ANP
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Telephone | 623-933-5991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP-0056
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License Number State | AZ
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