Provider Demographics
NPI:1942819230
Name:CARE ON PLLC
Entity Type:Organization
Organization Name:CARE ON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MANJU
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNAMENON
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:602-466-8281
Mailing Address - Street 1:2030 W BASELINE RD STE 182-746
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6574
Mailing Address - Country:US
Mailing Address - Phone:623-398-5602
Mailing Address - Fax:866-761-1196
Practice Address - Street 1:7171 S 51 AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85339-2923
Practice Address - Country:US
Practice Address - Phone:623-584-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty