Provider Demographics
NPI:1790752814
Name:ADRIANO, ANGELICA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:ADRIANO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9267 E DESERT ARROYOS
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6014
Mailing Address - Country:US
Mailing Address - Phone:480-292-9468
Mailing Address - Fax:
Practice Address - Street 1:2905 W WARNER RD
Practice Address - Street 2:SUITE 19
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1674
Practice Address - Country:US
Practice Address - Phone:480-899-2101
Practice Address - Fax:480-899-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN131235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ52220Medicare ID - Type Unspecified