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General NPI Number Information
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NPI Number | 1659850279
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Entity Type | Organization
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Legal Business Name | ADOBE PROVIDER GROUP
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 4041 S MCCLINTOCK DR STE 302
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City | TEMPE
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State | AZ
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Zip | 85282-5879
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Country | US
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Telephone | 480-339-1780
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 S MCCLINTOCK DR STE 302
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City | TEMPE
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State | AZ
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Zip | 85282-5879
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF INSPIRATIONAL OFFICER
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Name | PATRICIA DURYEA
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Credential |
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Telephone | 480-339-1780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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