NPI 1972261196 · live from the CMS NPI Registry
Alexander Etu
Registered Nurse, General Practice in Phoenix, AZ. National Provider Identifier 1972261196, active.
NPI record
| NPI | 1972261196 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, General Practice 163WG0000X |
| Practice location | 3207 S 73rd Dr, Phoenix, AZ 85043 |
| Practice phone | 623-238-9777 |
| Mailing address | 401 W Western Ave Unit 345, Avondale, AZ 85323 |
| Enumerated | December 5, 2021 |
| Last updated | December 5, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Home Health | 163WH0200X | RN215721 (AZ) |
| Registered Nurse, Psych/Mental Health, Adult | 163WP0809X | RN215721 (AZ) |
| Registered Nurse, General Practice primary | 163WG0000X | RN215721 (AZ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.