HOMETOWN HEALTHCARE LLC NPI 1720733249

NPI Information

NPI: 1720733249
Provider Name: HOMETOWN HEALTHCARE LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 03D2256869

Address:
3001 N MAIN ST STE 1B
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (480) 231-3974
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HOMETOWN HEALTHCARE LLC is a family nurse practitioner in Prescott Valley, AZ. HOMETOWN HEALTHCARE LLC NPI is 1720733249. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3001 N MAIN ST STE 1B
PRESCOTT VALLEY, AZ
ZIP 86314-215
Phone: (480) 231-3974

The provider's authorized official is Cassei Gringo .
The authorized official title is Owner and has the following contact phone number (480) 231-3974.

The CLIA number assigned to this NPI record is 03D2256869 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2022 and was last updated on 2/14/2022.

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	363LF0000X	Nurse Practitioner	Family			Yes

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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