Organization
AZ ADVANCED WOUND CARE
Active
Organization
AZ ADVANCED WOUND CARE
Active
Other names
AZ Advanced Wound Care
Organization subpart
No
Provider details
NPI number
Authorized official
BREANNA N WALLER (DIRECTOR OF OPERATIONS)
(615) 723-2828
Entity
Organization
Contact information
Practice address
4838 E BASELINE RD., BLDG 2 STE 113, MESA, AZ 85206-4674
(602) 835-3809
(480) 944-0859
Mailing address
4838 E BASELINE RD STE 113, MESA, AZ 85206-4674
(602) 835-3809
(480) 944-0859
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
08/07/2026
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