Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | RN053123 | AZ |
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP7036 | AZ |
N | 363LW0102X | Nurse Practitioner - Women's Health | RN053123 | AZ |
NPI | 1083703045 |
---|---|
Provider Name | Joellen Beard Embry |
First Address | Scottsdale, AZ 85251-6632 |
Second Address | Mesa, AZ 85202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 04/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
431130 | (05) | AZ |
AP7036 | ARIZONA STATE BOARD OF NURSING (01) | AZ |