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General NPI Number Information
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NPI Number | 1528813219
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Entity Type | Individual
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Provider Name | ANDREW EARL RN
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Gender | Male
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 19820 N 7TH ST STE 140
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City | PHOENIX
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State | AZ
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Zip | 85024-1691
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Country | US
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Telephone | 623-487-7763
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Fax |
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Provider Business Mailing Address
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Address Line | 6916 W VILLA THERESA DR
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City | GLENDALE
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State | AZ
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Zip | 85308-8092
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Country | US
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Telephone | 602-312-8145
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RNP315668
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN172749
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License Number State | AZ
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