LACEY LEANN TAKHTAY (NPI# 1083258966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083258966 |
| Entity Type | Individual |
| Full Name | LACEY LEANN TAKHTAY |
| Credential | NP-C |
| Practice Address |
5750 W Thunderbird Rd Ste B200 Glendale AZ 85306-4664 |
| Mailing Address |
3600 Park East Dr Apt 444 Beachwood OH 44122-4356 |
| Practice Telephone | 6022221900 |
| Mailing Telephone | 9373080087 |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
232202 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5750 W THUNDERBIRD RD STE B200 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85306-4664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538181474 | Ken-ryu Han | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2006-07-23 |
| 1417508722 | Christina J Cudzewicz | Physician Assistant | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2019-09-27 |
| 1245785732 | Sho Grant | Physician Assistant | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2016-08-24 |
| 1124365531 | Canyon Urology Services LLC | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2013-01-07 |
| 1831354810 | John Mikel Hubanks | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2008-07-19 |
| 1740324912 | Philip Koi | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-02-19 |
| 1053455238 | Canyon State Urology, PC | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-02-19 |
| 1538205851 | Tracy Lynne Cumberland | Physician Assistant | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-01-30 |
| 1548284441 | Christopher S Stewart | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784648 | Michelle Weissgerber | Registered Nurse | 6640 W Maui Ln, Glendale, AZ 85306 | 2017-07-31 |
| 1427502947 | Az Interact LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6055 West Caribe Lane, Glendale, AZ 85306 | 2016-08-12 |
| 1649667635 | Richard Moreno Jr. | Physical Therapy Assistant | 6509 W Acapulco Ln, Glendale, AZ 85306 | 2015-04-17 |
| 1568863819 | Alternative Living for You | Assisted Living Facility | 5328 W. Tierra Buena Ln., Glendale, AZ 85306 | 2014-09-05 |
| 1649614561 | Matthew Brownell | Internal Medicine | 5555 W, Thunderbird, Banner Thunderbird Medical Center, Glendale, AZ 85306 | 2013-04-22 |
| 1366736266 | Miles Christenson | Speech-Language Pathologist | 14627 N 60th Ave, Glendale, AZ 85306 | 2011-06-08 |
| 1285928721 | Nathalie Tania Petein-alamshaw | Internal Medicine | 5555 W Thunderbird Road, Glendale, AZ 85306 | 2011-06-01 |
| 1134351869 | William J. Duff | Counselor | 5701 W. Talavi Boulevard, Suite 180, Phoenix, AZ 85306 | 2009-08-13 |
| 1538321369 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5422 W. Thunderbird, Suite 8, Glendale, AZ 85306 | 2008-07-02 |
| 1316109143 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5620 W. Thunderbird, Suite D3, Glendale, AZ 85306 | 2008-07-02 |
| Find all providers in zip 85306 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199481 | Steven Cleo Northern Jr. | Nurse Practitioner | 5820 W Greenway Rd Ste 124, Glendale, AZ 85306-3308 | 2020-09-17 |
| 1609493279 | Traci Marie Miramontes | Nurse Practitioner | 6001 W Northview Ave, Glendale, AZ 85301-1857 | 2020-06-30 |
| 1669097697 | Swazi Cromwell | Nurse Practitioner | 13408 N 53rd Ave, Glendale, AZ 85304-1378 | 2020-06-16 |
| 1922620590 | Bethany E Mainville | Nurse Practitioner | 8151 W Sierra Vista Dr, Glendale, AZ 85303-3217 | 2020-05-17 |
| 1184252678 | Revive Wellness and Rejuvenation LLC | Nurse Practitioner | 20229 N 67th Ave Ste C-a, Glendale, AZ 85308-6664 | 2020-03-30 |
| 1083247316 | Anna Lazzaro | Nurse Practitioner | 4760 W Ponderosa Ln, Glendale, AZ 85308-4872 | 2020-02-14 |
| 1760021422 | Judy Fong | Nurse Practitioner | 5220 W Dahlia Dr, Glendale, AZ 85304-1931 | 2019-12-29 |
| 1588207138 | Kristen Mitchell | Nurse Practitioner | 6922 W Kristal Way, Glendale, AZ 85308-5772 | 2019-10-25 |
| 1760038335 | Adrineh Kalantar Ohanian | Nurse Practitioner | 1139 E Lexington Dr, Glendale, CA 91206-3861 | 2019-08-09 |
| 1457904252 | Debra Goldman | Nurse Practitioner | 20325 N 51st Ave # 8, Glendale, AZ 85308-5674 | 2019-07-20 |
| Find all providers in GLENDALE | ||||
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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.