Organization
AGAVE POSTPARTUM WELLNESS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INTY ALLEN FNP (OWNER/PROVIDER)
(602) 384-1648
Entity
Organization
Contact information
Practice address
21725 N 20TH AVE, SUITE 101-102 #1019, PHOENIX, AZ 85027-2640
(602) 384-1648
Mailing address
21725 N 20TH AVE, SUITE 101-102 #1019, PHOENIX, AZ 85027-2640
(602) 384-1648
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
05/28/2021
Last updated
05/04/2022
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