Nina Nettles in Phoenix - Assisted Living, Mental Illness
Nina Nettles - NPI 1124165469
Nina Nettles is a Assisted Living, Mental Illness in Phoenix, Arizona. Nina Nettles practices all healthcare services and medical treatments related to Assisted Living, Mental Illness. The NPI Number for Nina Nettles is 1124165469. The last update date is 2008-06-16.
Nina Nettles's current location address is 3643 E Emile Zola Ave, Phoenix, Arizona. You can contact this provider via phone number 6028677500. The mailing address for Nina Nettles is 3643 E Emile Zola Ave, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Nina Nettles |
|---|---|
| Address | 3643 E Emile Zola Ave, Phoenix, Arizona |
| Phone Number | 6028677500 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Nettles Fae Nina |
| Telephone Number | 6028677500 |
NPI Number Detail
| NPI Number | 1124165469 |
|---|---|
| Provider Enumeration Date | 2007-01-30 |
| Last Updated Date | 2008-06-16 |
Provider Mailing Address Detail
| Address | 3643 E Emile Zola Ave |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850326219 |
| Phone Number | 6028677500 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Assisted Living, Mental Illness |
|---|---|
| Taxonomy | 3104A0625X |
| Licence No | BH2458 |
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Definition: A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff w |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 873936 | AZ | -- | |
| BH2458 | AZ | STATE LICENCE |
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What is the unique identifier code issued to Nina Nettles by the Centers for Medicare & Medicaid Services?
The Nina Nettles has been assigned the NPI (National Provider Identifier) 1124165469. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Nina Nettles?
The Nina Nettles is physically situated at 3643 E Emile Zola Ave, in the city of Phoenix, state of AZ, with the postal code 850326219.
What is Nina Nettles's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Nina Nettles's specialized field of practice is Assisted Living, Mental Illness, and the corresponding taxonomy code that categorizes this area of specialization is 3104A0625X.
On what date did the Centers for Medicare & Medicaid Services issue the 1124165469 to Nina Nettles?
The Nina Nettles received its 1124165469 assignment from the Centers for Medicare & Medicaid Services on 2007-01-30.
As of what date were the details related to Nina Nettles most recently updated or revised?
The information pertaining to Nina Nettles, including its address, specialty, and other relevant details, was last updated or revised on 2008-06-16.