Provider Demographics
NPI:1639471253
Name:MAURER, NICOLA JANE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:JANE
Last Name:MAURER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 S DOBSON RD
Mailing Address - Street 2:STE 203
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6457
Mailing Address - Country:US
Mailing Address - Phone:480-376-2170
Mailing Address - Fax:480-376-2169
Practice Address - Street 1:5750 W THUNDERBIRD RD STE D400
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4668
Practice Address - Country:US
Practice Address - Phone:602-298-8977
Practice Address - Fax:602-298-1787
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP3884363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health