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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LP045315AZMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Agua Fria Union High School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Avondale, AZ

All providers in Avondale, AZ · Licensed Practical Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.