| Mobile NP PLLC | |
|
5807 E Vernon Ave Scottsdale AZ 85257-1941 | |
| (602) 935-7003 | |
| Not Available |
| Full Name | Mobile NP PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 5807 E Vernon Ave, Scottsdale, Arizona |
| Authorized Official Name and Position | Donna Serrano (ACCESS MANAGER) |
| Authorized Official Contact | 4809079900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile NP PLLC 5807 E Vernon Ave Scottsdale AZ 85257-1941 | Mobile NP PLLC 5807 E Vernon Ave Scottsdale AZ 85257-1941 Ph: (602) 935-7003 |
| NPI Number | 1184238164 |
|---|---|
| Provider Enumeration Date | 09/07/2020 |
| Last Update Date | 09/07/2020 |
| Certification Date | 09/07/2020 |
| Medicare PECOS PAC ID | 0446660518 |
|---|---|
| Medicare Enrollment ID | O20201029003158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184238164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Heidi a Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508942954 PECOS PAC ID: 7618257551 Enrollment ID: I20161209001526 |
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