Individual provider · Type 1 NPI
Peter Paul Moheb Hennis, AGNP
Gerontology Nurse Practitioner · Casa Grande, AZ
NPI number
1588233175
Active
Practice location
520 N Camino Mercado Ste 1
Casa Grande, AZ 85122-5754
Fax (480) 494-2771
Mailing address
2451 E Baseline Rd
Gilbert, AZ 85234-2471
Other practice locations
- 2451 E Baseline Rd Ste 425, Gilbert, AZ 85234-0049 · (480) 494-2770
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 258473 (AZ) |
Gerontology Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1588233175
Peter Paul Moheb Hennis, AGNP's National Provider Identifier is 1588233175, issued on Jun 18, 2021. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Casa Grande, AZ. The record was last updated on Oct 17, 2024.