Individual
MR. TIMOTHY CHARLES MARKANTES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
500 W THOMAS RD STE 230, PHOENIX, AZ 85013-4245
(602) 406-9999
Mailing address
500 W THOMAS RD STE 230, PHOENIX, AZ 85013-4245
(602) 406-9999
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP3411
AZ
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
AP3278
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163191
—
AZ
Enumeration date
03/30/2012
Last updated
10/18/2016
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