MEDICARE: ZABRINA PELL

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	176B00000X	Midwife	LM205	AZ

General Provider Information

NPI Number	:	1720523905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZABRINA PELL

Provider Business Mailing Address
First Line	:	17818 N 35TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-1309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17818 N 35TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-1309
Country	:	US
Telephone Number	:	623-748-7655
Fax Number	:	602-926-0999

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

Provider Enumeration Date	:	12/27/2016
Last Update Date	:	12/27/2016

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Directions to “ ZABRINA PELL ” Practice Location

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