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General NPI Number Information
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NPI Number | 1790648327
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Entity Type | Organization
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Legal Business Name | HG MAMA COACH LLC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 4512 W PEARCE RD
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City | LAVEEN
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State | AZ
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Zip | 85339
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Country | US
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Telephone | 602-499-3866
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Fax |
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Provider Business Mailing Address
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Address Line | 4611 E CHANDLER BLVD STE 112
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City | PHOENIX
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State | AZ
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Zip | 85048-0442
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Country | US
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Telephone | 602-499-3866
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HANNAH GAMMAGE
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Credential | NP
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Telephone | 775-530-5225
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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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