Provider Demographics
| NPI: | 1366217648 |
|---|---|
| Name: | NATIONWIDE PSYCHIATRY |
| Entity type: | Organization |
| Organization Name: | NATIONWIDE PSYCHIATRY |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CO-OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | GEORGETTE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | QUIE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 602-497-1588 |
| Mailing Address - Street 1: | 2982 N ALMA SCHOOL RD STE 2 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CHANDLER |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85224-6700 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 602-497-1588 |
| Mailing Address - Fax: | 602-581-7405 |
| Practice Address - Street 1: | 2982 N ALMA SCHOOL RD STE 2 |
| Practice Address - Street 2: | |
| Practice Address - City: | CHANDLER |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85224-6700 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 602-497-1588 |
| Practice Address - Fax: | 602-581-7405 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-11-16 |
| Last Update Date: | 2024-06-26 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |