1144514381 NPI number — INTERNATIONAL LIFE FLIGHT, INC.

Table of content: MRS. STEFANIE MICHELE SPESSARD C.R.N.P. (NPI 1194248120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144514381 NPI number — INTERNATIONAL LIFE FLIGHT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERNATIONAL LIFE FLIGHT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144514381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2710 E OLD TOWER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85034-6001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-777-2001
Provider Business Mailing Address Fax Number:
480-777-2011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2710 E OLD TOWER RD
Provider Second Line Business Practice Location Address:
SUITE 2010
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85034-6001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-777-2001
Provider Business Practice Location Address Fax Number:
480-777-2011
Provider Enumeration Date:
06/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KELLEY
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
FRANKLYN
Authorized Official Title or Position:
CEO & GENERAL COUNSEL
Authorized Official Telephone Number:
480-777-2001

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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