Provider Demographics
NPI:1619406238
Name:ALL ABOUT HEALTH & WELLNESS
Entity Type:Organization
Organization Name:ALL ABOUT HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELANA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:602-647-9085
Mailing Address - Street 1:8608 N 59TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-5404
Mailing Address - Country:US
Mailing Address - Phone:602-647-9085
Mailing Address - Fax:602-464-4671
Practice Address - Street 1:8608 N 59TH AVE STE B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-5404
Practice Address - Country:US
Practice Address - Phone:602-647-9085
Practice Address - Fax:602-464-4671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty