Provider Demographics
NPI:1952964660
Name:CENTURY HEALTH CARE NP LLC
Entity Type:Organization
Organization Name:CENTURY HEALTH CARE NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WITZEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:623-289-7223
Mailing Address - Street 1:12301 W BELL RD STE B107
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9706
Mailing Address - Country:US
Mailing Address - Phone:623-289-7223
Mailing Address - Fax:
Practice Address - Street 1:12301 W BELL RD STE B107
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9706
Practice Address - Country:US
Practice Address - Phone:623-289-7223
Practice Address - Fax:623-289-7829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty