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NPI Code Detail

MEDICARE: IMPULSE HEALTHCARE, PLLC

MEDICARE: IMPULSE HEALTHCARE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NR0400XRehabilitation Chiropractor
2163WA0400XAddiction (Substance Use Disorder) Registered Nurse
3163WP0000XPain Management Registered Nurse
4173000000XLegal Medicine
5204R00000XElectrodiagnostic Medicine Physician
6363LP2300XPrimary Care Nurse Practitioner

General Provider Information

NPI Number : 1023574324
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMPULSE HEALTHCARE, PLLC
Provider Business Mailing Address
First Line : 1204 E BASELINE RD STE 106
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1447
Country : US
Telephone Number : 602-560-1204
Fax Number : 602-560-1205
Provider Business Practice Location Address
First Line : 3201 W PEORIA AVE STE C500
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4600
Country : US
Telephone Number : 602-699-6353
Fax Number : 602-699-6354
Authorized Official
Title or Position : ADMINISTRATOR
Name : MATTHEW RHODES
Credential : NP
Telephone Number : 602-560-1204
Provider Enumeration Date : 02/12/2019
Last Update Date : 04/29/2019

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Directions to “IMPULSE HEALTHCARE, PLLC ” Practice Location

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