Organization · NPI-2

Glendale Healthcare LLC

Nurse Practitioner, Family · Glendale, AZ

NPI number1467869743
StatusActive
Last updated in NPPESJul 17, 2014

Details

NPI
1467869743
Entity type
Organization (NPI-2)
Legal business name
Glendale Healthcare LLC
Organization subpart
No
Enumeration date
Jul 17, 2014
Last updated
Jul 17, 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

Phone 602-889-5833

Authorized official

Martha Trujillo
Credentialing
6028895833

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