1275808685 NPI number — DIANE A SELL WHNP

Table of content: DR. MADELEINE NERI GUEVARA D.O. (NPI 1225254451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275808685 NPI number — DIANE A SELL WHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SELL
Provider First Name:
DIANE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1275808685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1444 E. LA VIEVE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85284-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-525-7981
Provider Business Mailing Address Fax Number:
480-456-4060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
312 N ALMA SCHOOL RD
Provider Second Line Business Practice Location Address:
SUITE 9C
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224-4354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-963-2720
Provider Business Practice Location Address Fax Number:
480-857-0468
Provider Enumeration Date:
03/19/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  RN040016 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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