=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639045016
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIA BLAZEK NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2025
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7012 E GREENWAY PKWY UNIT 140
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-685-2647
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17777 N SCOTTSDALE RD APT 2086
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-596-1703
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | TEMP263753
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------