Provider Demographics
NPI:1750997425
Name:RAMELLA, MARIA ANNETTE (FNP-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANNETTE
Last Name:RAMELLA
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 1:42 W ROYAL PALM RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5665
Mailing Address - Country:US
Mailing Address - Phone:602-882-7492
Mailing Address - Fax:
Practice Address - Street 1:9250 N 3RD ST STE 2035
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2437
Practice Address - Country:US
Practice Address - Phone:602-786-0175
Practice Address - Fax:602-674-6253
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ244614363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner