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General NPI Number Information
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NPI Number | 1578126611
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Entity Type | Individual
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Provider Name | ANGEL ENCINIAS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 6702 W BETHANY HOME RD
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City | GLENDALE
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State | AZ
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Zip | 85303-4402
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Country | US
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Telephone | 234-656-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 10040 W JASMINE TRL
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City | PEORIA
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State | AZ
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Zip | 85383-3370
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Country | US
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Telephone | 602-481-2599
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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 | 224160
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License Number State | AZ
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