NICOLE FREEZE (NPI# 1144658022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144658022 |
| Entity Type | Individual |
| Full Name | NICOLE FREEZE |
| Credential | PA-C |
| Practice Address |
Bmda-banner Gateway Medical Center 1900 N. Higley Road Gilbert AZ 85234 |
| Mailing Address |
2940 E. Banner Gateway Drive Suite 450 Gilbert AZ 85234 |
| Practice Telephone | 4802563430 |
| Practice Fax Number | 4802563682 |
| Mailing Telephone | 4802563430 |
| Mailing Fax Number | 4802563682 |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2018-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5520 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 863329 | 05 |
| Street Address |
BMDA-BANNER GATEWAY MEDICAL CENTER 1900 N. HIGLEY ROAD |
| City | GILBERT |
| State | AZ |
| Zip Code | 85234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| 1073152070 | American Care Concepts Hospice LLC | Hospice Care, Community Based | 765 N. Lindsay Rd., Ste. 208, Gilbert, AZ 85234 | 2019-12-23 |
| 1457918864 | Intuitive Healing Counseling Services, Pllc | Counselor | 3303 E Baseline Rd, Building 5, Suite 109, Gilbert, AZ 85234 | 2019-05-21 |
| 1487123907 | San Tan Behavioral Health Services LLC | Respite Care | 2671 East Vermont Court, Gilbert, AZ 85234 | 2018-11-14 |
| 1770052292 | San Tan Behavioral Health Services | Respite Care | 3970 East Juanita Avenue, Gilbert, AZ 85234 | 2018-11-14 |
| 1891262887 | Victoria Elizabeth Klennertt | Behavior Technician | 3503 E Michelle Way, Gilbert, AZ 85234 | 2018-10-27 |
| 1225503634 | Julia Elizabeth Wiens | Social Worker | 3651 E Baseline Rd Ste 120, Gilbert, AZ 85234 | 2018-10-11 |
| 1295219798 | Raylene Dawn Cargiulo | Registered Nurse | 55 S. Greenfield Rd., Gilbert, AZ 85234 | 2018-09-20 |
| 1346729092 | Katherine M Winegar | Nurse Practitioner | Banner Md Anderson Cancer Center- Administration Office, 2940 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-08-13 |
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| Find all providers in zip 85234 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1235349168 | Debra K Hatton | Physician Assistant | 3684 E Sierra Madre Ave, Gilbert, AZ 85296-1883 | 2007-05-22 |
| 1831115690 | Evans Surgical Associates PC | Physician Assistant | 1325 N Fiesta Blvd Ste 3, Gilbert, AZ 85233-1609 | 2006-07-14 |
| 1649229006 | Richard A Lease | Physician Assistant | 2966 E Warbler Rd, Gilbert, AZ 85297-8145 | 2006-05-10 |
| 1023072121 | Chris Brooks | Physician Assistant | 1150 W Sherri Dr, Gilbert, AZ 85233-7944 | 2006-04-14 |
| 1649233040 | Jose Luis Guzman | Physician Assistant | 1325 N Fiesta Blvd, Suite 3, Gilbert, AZ 85233-1609 | 2006-04-08 |
| 1194785535 | Aaron Allen | Physician Assistant | 1094 S Gilbert Rd, Suite 203, Gilbert, AZ 85296-3445 | 2006-03-27 |
| 1417957556 | Beth Erickson Foley | Physician Assistant | 2940 E Banner Gateway Dr, Suite 200, Gilbert, AZ 85234-2168 | 2005-07-29 |
| 1114558491 | Colby Rhel Horton | Physician Assistant | 2946 E Banner Gateway Drive, Gilbert, AZ 85234 | 2020-01-27 |
| 1154896058 | Jamie Lee Boma | Physician Assistant | 2946 E Banner Gateway Dr, Gilbert, AZ 85234 | 2018-10-06 |
| Find all providers in GILBERT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.