MOBILE MENDY LLC NPI 1770251068

NPI Information

NPI: 1770251068
Provider Name: MOBILE MENDY LLC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 03D2233350

Address:
829 E STEINBECK DR
ANTHEM, AZ
ZIP 85086
Phone: (602) 769-1137
Get Directions

MOBILE MENDY LLC is a pediatrics nurse practitioner in Anthem, AZ. MOBILE MENDY LLC NPI is 1770251068. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

829 E STEINBECK DR
ANTHEM, AZ
ZIP 85086
Phone: (602) 769-1137

The provider's authorized official is Tara Forstie .
The authorized official title is Owner/provider and has the following contact phone number (602) 769-1137.

The CLIA number assigned to this NPI record is 03D2233350 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/1/2021 and was last updated on 9/1/2021.

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	363LA2100X	Nurse Practitioner	Acute Care			No
2	363LP0200X	Nurse Practitioner	Pediatrics			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	1285005470	OTHER	ARIZONA	NPI

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: 11/14/2023

NPI Synchronization or Removal

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