Provider Demographics
NPI:1306899653
Name:ASTUDILLO-TEE, GWENDOLYN LLANAS (FNP, RN)
Entity type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:LLANAS
Last Name:ASTUDILLO-TEE
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:MISS
Other - First Name:GWENDOLYN
Other - Middle Name:L
Other - Last Name:TEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6301 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3392
Mailing Address - Country:US
Mailing Address - Phone:480-838-3100
Mailing Address - Fax:480-838-3902
Practice Address - Street 1:6301 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3392
Practice Address - Country:US
Practice Address - Phone:480-838-3100
Practice Address - Fax:480-838-3902
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN053999163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse