Provider Demographics
NPI:1720381163
Name:STANCA, ALINA (FNP)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:STANCA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8034
Mailing Address - Country:US
Mailing Address - Phone:602-470-5000
Mailing Address - Fax:
Practice Address - Street 1:12428 W THUNDERBIRD RD
Practice Address - Street 2:EL MIRAGE FAMILY HEALTH CENTER
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-3113
Practice Address - Country:US
Practice Address - Phone:623-344-6500
Practice Address - Fax:623-344-6501
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ109734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ576748Medicaid
AZZ142146Medicare PIN