EDGE INTEGRATIVE WELLNESS LLC NPI 1215444393

NPI Information

NPI: 1215444393
Provider Name: EDGE INTEGRATIVE WELLNESS LLC
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Organization

Specialization: Women's Health

Address:
2450 N WILLOW RANCH RD
TUCSON, AZ
ZIP 85749
Phone: (520) 730-2534
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EDGE INTEGRATIVE WELLNESS LLC is a women's health nurse practitioner in Tucson, AZ. EDGE INTEGRATIVE WELLNESS LLC NPI is 1215444393. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2450 N WILLOW RANCH RD
TUCSON, AZ
ZIP 85749-705
Phone: (520) 730-2534

The provider's authorized official is Derek Head .
The authorized official title is Biller and has the following contact phone number (520) 730-2534.

The enumeration date for this NPI number is 1/10/2018 and was last updated on 1/10/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11937739	OTHER		CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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