Provider Demographics
NPI:1760526982
Name:BARREDA, NICOLE DENISE (NMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:DENISE
Last Name:BARREDA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-281-1797
Mailing Address - Fax:480-281-1798
Practice Address - Street 1:14362 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-281-1797
Practice Address - Fax:480-281-1798
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-733175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath