Organization · Type 2 NPI

Your Nurse Practitioner LLC

Gerontology Nurse Practitioner · Prescott Valley, AZ

NPI number 1346504818 Active

Practice location

6261 Boothwyn St
Prescott Valley, AZ 86314-6726

Call (928) 775-9057 Map

Mailing address

6261BOOTHWYN Street
Prescott Valley, AZ 86314-6726

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	RN039594 (AZ)

Gerontology Nurse Practitioner: Definition to come...

About NPI 1346504818

Your Nurse Practitioner LLC's National Provider Identifier is 1346504818, issued on Jun 29, 2012. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Prescott Valley, AZ. The record was last updated on Jun 29, 2012.