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General NPI Number Information
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NPI Number | 1740617588
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Entity Type | Organization
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Legal Business Name | ARIZONA HOUSECALLS LLC
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 2942 N 24TH ST SUITE 104
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City | PHOENIX
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State | AZ
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Zip | 85016-7844
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Country | US
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Telephone | 480-347-0310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 32417
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City | PHOENIX
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State | AZ
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Zip | 85064-2417
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Country | US
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Telephone | 480-347-0387
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JEANNETTE MARTINEZ
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Credential |
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Telephone | 480-347-0310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | AZ
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Taxonomy #2
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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 | AZ
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