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Organization
MOBILE MENDY LLC
Active
Organization
MOBILE MENDY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA FORSTIE CPNP-AC (OWNER/PROVIDER)
(602) 769-1137
Entity
Organization
Contact information
Practice address
829 E STEINBECK DR, ANTHEM, AZ 85086
(602) 769-1137
Mailing address
515 E CAREFREE HWY # 299, PHOENIX, AZ 85085-8839
(602) 769-1137
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
—
NULL
363LA2100X
Acute Care Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
Primary
—
NULL
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285005470
NPI
AZ
Enumeration date
09/01/2021
Last updated
09/01/2021
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