Provider Demographics
NPI:1790212322
Name:ATKINS, MARIA STEWART
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:STEWART
Last Name:ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 W PLANA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-8111
Mailing Address - Country:US
Mailing Address - Phone:480-395-3972
Mailing Address - Fax:
Practice Address - Street 1:1565 W PLANA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-8111
Practice Address - Country:US
Practice Address - Phone:480-395-3972
Practice Address - Fax:480-503-8138
Is Sole Proprietor?:No
Enumeration Date:2017-05-14
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ299660247200000X, 246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy