Provider Demographics
NPI:1508434895
Name:VIETOR, ATALIA (RN, BSN, CNOR, RNFA)
Entity Type:Individual
Prefix:
First Name:ATALIA
Middle Name:
Last Name:VIETOR
Suffix:
Gender:F
Credentials:RN, BSN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9139 W THUNDERBIRD RD STE 220
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15060 S 39TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6612
Practice Address - Country:US
Practice Address - Phone:480-332-7336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN193382163WG0000X, 163WS0121X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery