ADVANCED PRACTICE NURSE SOURCE, LLC – NPI #1790536654
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

Health Care Provider Taxonomy Code for Family Medicine

ADVANCED PRACTICE NURSE SOURCE, LLC is a provider located in GLENDALE, AZ. NPPES has assigned the NPI number 1790536654 to ADVANCED PRACTICE NURSE SOURCE, LLC on March 28, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADVANCED PRACTICE NURSE SOURCE, LLC below.

NPI Profile for
ADVANCED PRACTICE NURSE SOURCE, LLC

NPI Number
1790536654
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ADVANCED PRACTICE NURSE SOURCE, LLC
Primary location
12772 N 58TH AVE
GLENDALE, AZ 85304-1878
Phone: (801) 550-6059 Fax:
Mailing address
5830 W THUNDERBIRD RD STE B8118
GLENDALE, AZ 85306-4654
Phone: Fax:
Organization Subpart
No
Authorized Official
MELISSA SARHAN
CEO
Phone: (801) 550-6059
Updated
Certification Date
Mar 28, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.