Organization · NPI-2

Del Healthcare LLC

Nurse Practitioner, Family · Glendale, AZ

NPI number1124433990
StatusActive
Last updated in NPPESOct 28, 2014

Details

NPI
1124433990
Entity type
Organization (NPI-2)
Legal business name
Del Healthcare LLC
Organization subpart
No
Enumeration date
Jun 30, 2014
Last updated
Oct 28, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family––Yes
171M00000X Case Manager/Care Coordinator––

Practice location

6320 W Union Hills Dr
Ste. 1400b
Glendale, AZ 85308-1096

Phone 602-889-5833

Mailing address

6320 W Union Hills Dr
Ste. 1400b
Glendale, AZ 85308-1096

Authorized official

Ronald Vigneau
Owner
6028895833

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