Provider Demographics
NPI:1083774400
Name:NAZARIO, JANET K (NP, RN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:K
Last Name:NAZARIO
Suffix:
Gender:F
Credentials:NP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 N 15TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3328
Mailing Address - Country:US
Mailing Address - Phone:623-245-0505
Mailing Address - Fax:
Practice Address - Street 1:5040 N 15TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3328
Practice Address - Country:US
Practice Address - Phone:623-245-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN085528163WN0003X
AZAP 4013363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk