Provider Demographics
NPI:1326215401
Name:NP-PRIVATE PRACTICE ASSOC, LLC
Entity Type:Organization
Organization Name:NP-PRIVATE PRACTICE ASSOC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUMANN HEIL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-874-2900
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-874-2900
Mailing Address - Fax:480-874-2902
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-874-2900
Practice Address - Fax:480-874-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN056661363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ106130Medicare UPIN