Provider Demographics
NPI:1427784354
Name:GARRETT, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16671 N LITCHFIELD RD APT 112
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7066
Mailing Address - Country:US
Mailing Address - Phone:928-377-0529
Mailing Address - Fax:
Practice Address - Street 1:617 N SCOTTSDALE RD STE D
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4207
Practice Address - Country:US
Practice Address - Phone:480-990-3720
Practice Address - Fax:480-990-8085
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ218901164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty