Marina Antunez
Individual provider Active NPI Licensed Practical Nurse · Avondale, AZ
NPI 1497986798 · NPPES record last updated Aug 4, 2009
Key facts
- NPI
- 1497986798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LP045315 (AZ)
- Practice address
- 530 E Riley Dr
Avondale, AZ 85323-2154 - Phone
- (623) 932-7300
- Fax
- (623) 932-0650
- NPI assigned
- Aug 4, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| LP045315 | AZ | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agua Fria Union High School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP045315 | AZ | Yes |
Addresses
Primary practice location
530 E Riley Dr
Avondale, AZ 85323-2154
Mailing address
530 E Riley Dr
Avondale, AZ 85323-2154
Phone (623) 932-7300
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All providers in Avondale, AZ · Licensed Practical Nurse in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2009. 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.