Provider Demographics
NPI:1841558194
Name:ARIZONA VISITING NURSES
Entity type:Organization
Organization Name:ARIZONA VISITING NURSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:JON
Authorized Official - Last Name:MARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-820-0000
Mailing Address - Street 1:2659 W GUADALUPE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7254
Mailing Address - Country:US
Mailing Address - Phone:480-820-0000
Mailing Address - Fax:480-775-6565
Practice Address - Street 1:2659 W GUADALUPE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7254
Practice Address - Country:US
Practice Address - Phone:480-820-0000
Practice Address - Fax:480-775-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health