AGAVE SURGICAL SERVICES LLC (NPI# 1477026862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477026862 |
Entity Type | Organization |
Organization Name | AGAVE SURGICAL SERVICES LLC |
Practice Address |
2045 S Vineyard Ste 142 Mesa AZ 85210-6891 |
Practice Telephone | 4803306010 |
Mailing Telephone | 4803306010 |
Enumeration Date | 2019-01-08 |
Last Update Date | 2019-01-08 |
Authorized Official Name | BERNADETTE ANDALKAR (OWNER) |
Authorized Official Telephone | 5204908368 |
Authorized Official Credential | ACNP-BC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2045 S VINEYARD STE 142 |
City | MESA |
State | AZ |
Zip Code | 85210-6891 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851681498 | Bernadette Marie Andalkar | Nurse Practitioner | 2045 S Vineyard Ste 142, Mesa, AZ 85210 | 2011-04-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
Find all providers in zip 85210 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255955282 | Erica Leigh Whetten | Nurse Practitioner | 1520 S Dobson Rd Ste 218, Mesa, AZ 85202-4754 | 2020-06-05 |
1366097255 | Samantha Alice Polito | Nurse Practitioner | 6750 E Baywood Ave Ste 401, Mesa, AZ 85206-1749 | 2019-08-07 |
1396203113 | Rakhi Joshi | Nurse Practitioner | 2919 S Ellsworth Rd Ste 139, Mesa, AZ 85212-2168 | 2019-03-11 |
1457839896 | Noah Kipkorir Sang | Nurse Practitioner | 7525 E Broadway Rd Ste 11, Mesa, AZ 85208-1156 | 2018-07-28 |
1659828358 | Devon Lewis | Nurse Practitioner | 1701 N Sundial, Mesa, AZ 85205-3544 | 2016-09-10 |
1508210659 | Kristina Denise Bardwell | Nurse Practitioner | 1520 S Dobson Rd Ste 209, Mesa, AZ 85202-4753 | 2016-04-14 |
1639538986 | Mark Raymond Hinde | Nurse Practitioner | 1237 S Val Vista Dr Ste 122, Mesa, AZ 85204-6401 | 2016-02-15 |
1558751396 | Tami Howard | Nurse Practitioner | 6020 E Arbor Ave Ste 101, Mesa, AZ 85206-6102 | 2015-02-02 |
1003195025 | Aida E Amado | Nurse Practitioner | 10163 E Jacob Ave, Mesa, AZ 85209-7086 | 2011-08-08 |
1942595830 | Ruth Anne Skinner | Nurse Practitioner | 1434 N Delmar, Mesa, AZ 85203-3805 | 2011-06-18 |
Find all providers in MESA |
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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.