MEDICARE: MS. GEORGETTE C VODHI ANP-C

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	305S00000X	Point of Service	201050011NP	OR

General Provider Information

NPI Number	:	1962405480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GEORGETTE C VODHI ANP-C

Provider Business Mailing Address
First Line	:	9201 E MOUNTAIN VIEW RD STE 220
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5172
Country	:	US
Telephone Number	:	877-506-3627
Fax Number	:	877-506-4560

Provider Business Practice Location Address
First Line	:	9201 E MOUNTAIN VIEW RD STE 220
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-5172
Country	:	US
Telephone Number	:	877-506-3627
Fax Number	:	877-506-4560

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	07/28/2015

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