Organization · Type 2 NPI
Country Club Medical Weight Loss & Wellness PLLC
Family Nurse Practitioner · Mesa, AZ
NPI number
1205616398
Active
Practice location
1855 S Country Club Dr Ste 111-130
Mesa, AZ 85210-6037
Mailing address
PO Box 697
Laveen, AZ 85339-0697
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1205616398
Country Club Medical Weight Loss & Wellness PLLC's National Provider Identifier is 1205616398, issued on Oct 5, 2023. 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 5, 2023.