Individual
REBEKAH NORDTVEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14044 W CAMELBACK RD STE 118, LITCHFIELD PARK, AZ 85340
(623) 547-2600
Mailing address
14044 W CAMELBACK RD STE 118, LITCHFIELD PARK, AZ 85340-9481
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7316
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7316
PHYSICIAN ASSISTANT
AZ
Enumeration date
10/20/2018
Last updated
11/13/2018
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