Provider Demographics
NPI:1104259290
Name:DEPENDABLE NURSES
Entity type:Organization
Organization Name:DEPENDABLE NURSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:QUARTNEI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:714-471-3644
Mailing Address - Street 1:5021 N 20TH ST
Mailing Address - Street 2:UNIT45046
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4166
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5021 N 20TH ST
Practice Address - Street 2:UNIT45046
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4166
Practice Address - Country:US
Practice Address - Phone:714-471-3644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health