MEDICARE: MOBILE NP 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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1184238164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE NP PLLC

Provider Business Mailing Address
First Line	:	5807 E VERNON AVE
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-1941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 E VERNON AVE
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-1941
Country	:	US
Telephone Number	:	602-935-7003
Fax Number	:

Authorized Official
Title or Position	:	ACCESS MANAGER
Name	:	DONNA SERRANO
Credential	:
Telephone Number	:	480-907-9900

Provider Enumeration Date	:	09/07/2020
Last Update Date	:	09/07/2020

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Directions to “MOBILE NP PLLC ” Practice Location

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