Provider Demographics
NPI:1932664323
Name:LUXE WOMEN'S HEALTH LLC
Entity Type:Organization
Organization Name:LUXE WOMEN'S HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT-BENNION
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CNS, APRN
Authorized Official - Phone:480-550-5117
Mailing Address - Street 1:22424 S ELLSWORTH LOOP RD UNIT 1007
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7124
Mailing Address - Country:US
Mailing Address - Phone:480-550-5117
Mailing Address - Fax:833-424-7117
Practice Address - Street 1:21321 E OCOTILLO RD STE 126
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5995
Practice Address - Country:US
Practice Address - Phone:480-550-5117
Practice Address - Fax:833-424-7117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-10
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ978215Medicaid