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Organization

FORTITUDE HEALTHCARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NIKKI VAUGHAN RN (ADMINISTRATOR)
(602) 279-0044
Entity
Organization

Contact information

Practice address
5133 N CENTRAL AVE STE 204, PHOENIX, AZ 85012-1438
(602) 279-0044
(602) 279-0088
Mailing address
5133 N CENTRAL AVE STE 204, PHOENIX, AZ 85012-1438
(602) 279-0044
(602) 279-0088

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Enumeration date
07/17/2018
Last updated
10/08/2018
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