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FATIMA CABAL TAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3202 E GREENWAY RD, PHOENIX, AZ 85032-4548
(602) 325-5577
(415) 252-7176
Mailing address
21618 N 44TH PL, PHOENIX, AZ 85050-6934
(480) 513-0793
(480) 513-0793

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704203126
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
AP3316
AZ
363LG0600X
Gerontology Nurse Practitioner
C-APN.0002138-C-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
470246910
MI
05
470247810
MI
01
FC203126
BLUE SHIELD
MI
01
P00231988
RR MEDICARE
MI
Enumeration date
09/29/2006
Last updated
04/17/2025
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