MEDICARE: ABIGAIL C MENDEZ FNP-C

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	363LF0000X	Family Nurse Practitioner	305742	AZ

General Provider Information

NPI Number	:	1477305134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL C MENDEZ FNP-C

Provider Business Mailing Address
First Line	:	3260 N HAYDEN RD STE 112
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-6650
Country	:	US
Telephone Number	:	602-264-9100
Fax Number	:	602-264-9101

Provider Business Practice Location Address
First Line	:	9250 N 3RD ST STE 4035
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2434
Country	:	US
Telephone Number	:	602-279-3575
Fax Number	:	602-279-2666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	12/04/2024

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