Provider Demographics
NPI:1093488231
Name:CHILDS, AUSTIN (MSN)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:CHILDS
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 W ASPERA BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7947
Mailing Address - Country:US
Mailing Address - Phone:623-248-2100
Mailing Address - Fax:
Practice Address - Street 1:7701 W ASPERA BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7947
Practice Address - Country:US
Practice Address - Phone:623-248-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-25
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN192874163W00000X
AZ262007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse