Organization · Type 2 NPI
Mesa Physical Medicine PLLC
Primary Care Nurse Practitioner · Mesa, AZ
NPI number
1154774305
Active
Practice location
10207 E Hampton Ave Ste 105
Mesa, AZ 85209-3336
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | AP4338 (AZ) |
Primary Care Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1154774305
Mesa Physical Medicine PLLC's National Provider Identifier is 1154774305, issued on Jul 22, 2016. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Mesa, AZ. The record was last updated on Sep 24, 2026.