Provider Demographics
NPI:1093156234
Name:BACK TO HEALTH NURSING
Entity Type:Organization
Organization Name:BACK TO HEALTH NURSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STILKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-820-8200
Mailing Address - Street 1:2659 W GUADALUPE RD
Mailing Address - Street 2:D107
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7254
Mailing Address - Country:US
Mailing Address - Phone:480-820-8200
Mailing Address - Fax:480-820-4141
Practice Address - Street 1:2659 W GUADALUPE RD
Practice Address - Street 2:D 107
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7254
Practice Address - Country:US
Practice Address - Phone:480-820-8200
Practice Address - Fax:480-820-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion