LITTLE SANCTUARY HEALTH CENTER NPI 1326683376

NPI Information

NPI: 1326683376
Provider Name: LITTLE SANCTUARY HEALTH CENTER
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 03D2171940

Address:
840 W SOUTHERN AVE
MESA, AZ
ZIP 85210
Phone: (480) 572-9759
Get Directions

LITTLE SANCTUARY HEALTH CENTER is a primary care nurse practitioner in Mesa, AZ. LITTLE SANCTUARY HEALTH CENTER NPI is 1326683376. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

840 W SOUTHERN AVE
MESA, AZ
ZIP 85210-901
Phone: (480) 572-9759

The provider's authorized official is Adella Cordova .
The authorized official title is Manager and has the following contact phone number (623) 326-1055.

The CLIA number assigned to this NPI record is 03D2171940 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2019 and was last updated on 11/14/2019.

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	363LP2300X	Nurse Practitioner	Primary Care			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	954275	MEDICAID	ARIZONA

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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