Pearl Abbott
Individual provider Active NPI Nurse's Aide · Peoria, AZ
NPI 1245829159 · NPPES record last updated Jan 14, 2021
Key facts
- NPI
- 1245829159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 249604 (AZ)
- Practice address
- 12740 N Plaza del Rio Blvd
Peoria, AZ 85381-8100 - Phone
- (480) 581-3600
- NPI assigned
- Jan 14, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 249604 | AZ | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 249604 | AZ | Yes |
Addresses
Primary practice location
12740 N Plaza del Rio Blvd
Peoria, AZ 85381-8100
Mailing address
5805 S 129TH Ave
Avondale, AZ 85323-9731
Phone (801) 762-7722
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.