Banner Physician Super Specialists Arizona LLC
Nutritionist, Nutrition, Education in Mesa, AZ. Organization (NPI-2).
NPI number1790337665
StatusActive
Last updated in NPPESDec 28, 2021
Details
- NPI
- 1790337665
- Entity type
- Organization (NPI-2)
- Legal business name
- Banner Physician Super Specialists Arizona LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 11, 2019
- Certification date
- Dec 28, 2021
- Last updated
- Dec 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133NN1002X | Nutritionist, Nutrition, Education | – | – | Yes |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
1450 S Dobson Rd Ste B221Mesa, AZ 85202-4745
Phone 480-827-5370
Mailing address
2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Authorized official
Dennis Laraway
Cfo
6027474000
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Nutrition Education Nutritionist providers in Mesa, AZ
- William Bozeman, DHSCNPI 1467319889
- Christine Inez CintronNPI 1306345780
- Cassea Marie Herscheberg, NUTRITIONISTNPI 1770472078
- Melissa LopezNPI 1205650298
- Angela SnyderNPI 1811842503
All 6 Nutrition Education Nutritionist providers in Mesa · All 13,507 providers in Mesa
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.