Provider Demographics
NPI:1760527725
Name:NORTH VALLEY SURGICAL ASSISTING, INC.
Entity Type:Organization
Organization Name:NORTH VALLEY SURGICAL ASSISTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNFA/PRESIDENT OF NVALLEY SURGICAL
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:602-622-1929
Mailing Address - Street 1:POB 83270
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85071-3270
Mailing Address - Country:US
Mailing Address - Phone:602-622-1929
Mailing Address - Fax:602-942-6188
Practice Address - Street 1:4150 W. PEORIA AVE
Practice Address - Street 2:STE 121
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:602-622-1929
Practice Address - Fax:602-942-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RN101426163WR0006X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty