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General NPI Number Information
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NPI Number | 1619406238
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Entity Type | Organization
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Legal Business Name | ALL ABOUT HEALTH & WELLNESS
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 8608 N 59TH AVE STE B
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City | GLENDALE
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State | AZ
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Zip | 85302-5404
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Country | US
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Telephone | 602-647-9085
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Fax | 602-464-4671
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Provider Business Mailing Address
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Address Line | 8608 N 59TH AVE STE B
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City | GLENDALE
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State | AZ
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Zip | 85302-5404
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Country | US
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Telephone | 602-647-9085
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Fax | 602-464-4671
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. DELANA KIM GARDNER
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Credential | FNP-C
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Telephone | 602-647-9085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP5166
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License Number State | AZ
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