MEDICARE: MS. AIMEE MAXFIELD 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	363L00000X	Nurse Practitioner	95025732	CA

General Provider Information

NPI Number	:	1578336137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AIMEE MAXFIELD FNP-C

Provider Business Mailing Address
First Line	:	1808 W STRAIGHT ARROW LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-6357
Country	:	US
Telephone Number	:	757-663-2393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1808 W STRAIGHT ARROW LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-6357
Country	:	US
Telephone Number	:	757-663-2393
Fax Number	:

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

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	11/03/2023

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