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General NPI Number Information
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NPI Number | 1538981055
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Entity Type | Individual
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Provider Name | NARDIN HERMIZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 16222 N 59TH AVE STE D170
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City | GLENDALE
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State | AZ
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Zip | 85306-1708
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Country | US
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Telephone | 530-364-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 W VILLA MARIA DR
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City | GLENDALE
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State | AZ
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Zip | 85308-1339
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Country | US
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Telephone | 224-678-8526
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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 | 316059
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License Number State | AZ
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