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General NPI Number Information
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NPI Number | 1841688389
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Entity Type | Organization
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Legal Business Name | CORDES LAKES MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 20172 E STAGECOACH TRL
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City | MAYER
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State | AZ
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Zip | 86333-2357
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Country | US
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Telephone | 928-772-1673
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Fax | 602-218-4443
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Provider Business Mailing Address
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Address Line | 15029 N THOMPSON PEAK PKWY STE B111-438
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2217
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Country | US
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Telephone | 623-239-8534
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CINDY M BROWN
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Credential | FNP-C
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Telephone | 928-772-1673
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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 | AP3224
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License Number State | AZ
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