Organization · Type 2 NPI
Brave Athletics & Wellness LLC
Family Nurse Practitioner · Mesa, AZ
NPI number
1104738798
Active
Practice location
9932 E Rotation Dr
Mesa, AZ 85212-9009
Mailing address
1155 S Power Rd Ste 114, #581
Mesa, AZ 85206-3716
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
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About NPI 1104738798
Brave Athletics & Wellness LLC's National Provider Identifier is 1104738798, issued on Sep 19, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Mesa, AZ. The record was last updated on Oct 1, 2026.