LITTLE SANCTUARY HEALTH CENTER (NPI# 1326683376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326683376 |
| Entity Type | Organization |
| Organization Name | LITTLE SANCTUARY HEALTH CENTER |
| Practice Address |
840 W Southern Ave Mesa AZ 85210-4901 |
| Practice Telephone | 4805729759 |
| Mailing Telephone | 4805729759 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |
| Authorized Official Name | ADELLA CORDOVA (MANAGER) |
| Authorized Official Telephone | 6233261055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 954275 | 05 |
| Street Address |
840 W SOUTHERN AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85210-4901 |
| 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 | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864202 | Soma Care, LLC | Nurse Practitioner | 6944 E Broadway Rd Ste A, Mesa, AZ 85208-1916 | 2020-08-31 |
| 1245851955 | Amy Rachelle Dunn | Nurse Practitioner | 7563 E Plata Ave, Mesa, AZ 85212-9729 | 2020-05-04 |
| 1306356746 | Christine Elizabeth Claybrook | Nurse Practitioner | 6859 E Rembrandt Ave Ste 117, Mesa, AZ 85212-3630 | 2017-10-11 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1730320623 | Kay Lynn Southwell | Nurse Practitioner | 6242 E Arbor Ave Suite 111, Mesa, AZ 85206-2809 | 2009-03-23 |
| 1306491113 | Abigail Lee Moreno | Nurse Practitioner | 7525 E Broadway Rd Ste 11, Mesa, AZ 85208-1156 | 2019-08-08 |
| 1932623469 | John Risi | Nurse Practitioner | 2266 S Dobson Rd Ste 200, Mesa, AZ 85202 | 2017-07-26 |
| 1154774305 | Mesa Physical Medicine Pllc | Nurse Practitioner | 2919 S Ellsworth Rd, Suite 102, Mesa, AZ 85212-2164 | 2016-07-22 |
| 1720467418 | Sung E Cho | Nurse Practitioner | 1705 W Main St, Mesa, AZ 85201-6920 | 2015-05-27 |
| 1770810715 | Priscilla Marie Luong | Nurse Practitioner | 5602 E Main St, Mesa, AZ 85205-8813 | 2009-11-12 |
| 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.