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NPI Code Detail

MEDICARE: ESTHER LORRAINE BEARDT L.P.N.

MEDICARE:   ESTHER LORRAINE BEARDT  L.P.N.
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 NurseLP021715AZ

General Provider Information

NPI Number : 1649465360
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTHER LORRAINE BEARDT L.P.N.
Provider Business Mailing Address
First Line : 4036 W GROVERS AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-3027
Country : US
Telephone Number : 602-770-2626
Fax Number : 602-978-6253
Provider Business Practice Location Address
First Line : 711 E MISSOURI AVE
Second Line : SUITE 110
City : PHOENIX
State : AZ
Zip : 85014-2824
Country : US
Telephone Number : 602-433-1200
Fax Number : 602-604-9690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2007
Last Update Date : 09/06/2007

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Directions to “ ESTHER LORRAINE BEARDT L.P.N.” Practice Location

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