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NPI Code Detail

MEDICARE: MRS. SCARLETT P BAEZA LPN

MEDICARE:  MRS. SCARLETT P BAEZA  LPN
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
1164W00000XLicensed Practical NurseLP003357AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053448266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SCARLETT P BAEZA LPN
Provider Business Mailing Address
First Line : 1226 W OSBORN RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3618
Country : US
Telephone Number : 602-707-2615
Fax Number : 602-707-2040
Provider Business Practice Location Address
First Line : 1526 W MISSOURI AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-2616
Country : US
Telephone Number : 602-707-2615
Fax Number : 602-707-2040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/09/2007

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Directions to “ MRS. SCARLETT P BAEZA LPN” Practice Location

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