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NPI Code Detail

MEDICARE: CAROLE ANNE MASELLI LPN

MEDICARE: CAROLE ANNE MASELLI 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 NurseLP034799AZ

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 : 1598841074
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE ANNE MASELLI LPN
Provider Business Mailing Address
First Line : 19007 N 69TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-5765
Country : US
Telephone Number : 623-572-9080
Fax Number :
Provider Business Practice Location Address
First Line : 10251 N 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-1305
Country : US
Telephone Number : 602-995-9406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 07/09/2007

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Directions to “ CAROLE ANNE MASELLI LPN” Practice Location

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