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General NPI Number Information
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NPI Number | 1831908193
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Entity Type | Organization
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Legal Business Name | NORTHWEST HBP MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1551 E TANGERINE RD
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City | ORO VALLEY
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State | AZ
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Zip | 85755-6213
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Country | US
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Telephone | 877-848-1457
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Fax | 659-235-6176
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Provider Business Mailing Address
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Address Line | PO BOX 680060
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City | FRANKLIN
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State | TN
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Zip | 37068-0060
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Country | US
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Telephone | 877-848-1457
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Fax | 659-235-6176
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Authorized Official
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Title or Position | SR. DIRECTOR
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Name | WENDI KEETON
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Credential |
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Telephone | 615-628-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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