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General NPI Number Information
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NPI Number | 1740691096
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Entity Type | Individual
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Provider Name | NATHAN ESTEP
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Gender | Male
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 550 W MARYLAND AVE UNIT 123
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City | PHOENIX
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State | AZ
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Zip | 85013-1363
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Country | US
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Telephone | 816-262-3191
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT# 42065 PO BOX 650823
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City | DALLAS
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State | TX
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Zip | 75265-6662
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Country | US
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Telephone | 602-200-9021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN187379
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA1052
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License Number State | AZ
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