MEDICARE: MS. GEORGETA ELENA MIHAILOVICI 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	AP1224	AZ

General Provider Information

NPI Number	:	1952497182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GEORGETA ELENA MIHAILOVICI FNP

Provider Business Mailing Address
First Line	:	5734 W GROVERS AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-1221
Country	:	US
Telephone Number	:	602-978-1295
Fax Number	:

Provider Business Practice Location Address
First Line	:	17220 N BOSWELL BLVD
Second Line	:
City	:	SUN CITY
State	:	AZ
Zip	:	85373-2000
Country	:	US
Telephone Number	:	623-876-9100
Fax Number	:	623-876-9300

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	01/21/2009

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