MEDICARE: ALINA STANCA FNP

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	109734	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720381163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALINA STANCA FNP

Provider Business Mailing Address
First Line	:	2929 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-8034
Country	:	US
Telephone Number	:	602-470-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	12428 W THUNDERBIRD RD
Second Line	:	EL MIRAGE FAMILY HEALTH CENTER
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-3113
Country	:	US
Telephone Number	:	623-344-6500
Fax Number	:	623-344-6501

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

Provider Enumeration Date	:	12/07/2010
Last Update Date	:	08/24/2011

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