Organization · Type 2 NPI

Identity Hormones LLC

Adult Medicine Physician · Phoenix, AZ

NPI number 1326642372 Active

Practice location

100 E Camelback Rd Ste 108
Phoenix, AZ 85012-1061

Specialties and licenses

Taxonomy	Code	License
Adult Medicine Physician Primary	207QA0505X	None listed
Primary Care Clinic/Center	261QP2300X	None listed

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

3 other providers at this address

Michael Derek Jaorasdr, APRN, FNP-CFamily Nurse Practitioner Phoenix, AZ NPI 1851697007
Sunshine Rowdy Erisman, RNRegistered Nurse Phoenix, AZ NPI 1972417798
Zachary Timothy Scott BraggPrimary Care Nurse Practitioner Phoenix, AZ NPI 1962374405

Other adult medicine physician providers in Phoenix

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NPI record

NPI: 1326642372
Entity type: Organization (Type 2)
Issued: Nov 30, 2020
Last updated: Nov 11, 2024
Status: Active

Other names

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Identity Hormones LLC · doing business as
Identity Hormones LLC · doing business as

Authorized official

Amanda Wilkinson
Business Operations Director
(702) 818-0446

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1326642372

Identity Hormones LLC's National Provider Identifier is 1326642372, issued on Nov 30, 2020. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Phoenix, AZ. The record was last updated on Nov 11, 2024.