Provider Demographics
NPI:1457199523
Name:CREDENTIALING AND BILLING LLC
Entity type:Organization
Organization Name:CREDENTIALING AND BILLING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC, MSCP
Authorized Official - Phone:403-589-6960
Mailing Address - Street 1:3101 N CENTRAL AVE STE 1834869
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2645
Mailing Address - Country:US
Mailing Address - Phone:403-589-6960
Mailing Address - Fax:208-218-0544
Practice Address - Street 1:3101 N CENTRAL AVE STE 1834869
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2645
Practice Address - Country:US
Practice Address - Phone:403-589-6960
Practice Address - Fax:208-218-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WM0102XNursing Service ProvidersRegistered NurseMaternal NewbornGroup - Multi-Specialty
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-RiskGroup - Multi-Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Multi-Specialty
No163WP1700XNursing Service ProvidersRegistered NursePerinatalGroup - Multi-Specialty
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatalGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty