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General NPI Number Information
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NPI Number | 1669298873
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Entity Type | Organization
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Legal Business Name | PRIDE HEALTH & WELLNESS SOLUTIONS
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 633 S ESTRELLA PKWY STE 3-120
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City | GOODYEAR
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State | AZ
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Zip | 85338-9331
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Country | US
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Telephone | 623-306-7200
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Fax | 855-576-5012
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Provider Business Mailing Address
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Address Line | 633 S ESTRELLA PKWY STE 3-120
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City | GOODYEAR
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State | AZ
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Zip | 85338-9331
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Country | US
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Telephone | 623-306-7200
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Fax | 855-576-5012
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. MARIAN RAMIREZ BAUTISTA-DE-LEON
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Credential | NURSE PRACTITIONER
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Telephone | 561-309-4434
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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 |
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License Number State |
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