Organization Name: | ANTHEM TOTAL HEALTH |
NPI Number: | 1366803306 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VERONCIA J FOX (NP/ CO-OWNER) |
Mailing Address: | 41818 N Venture Dr Suite 150 Anthem |
State: | AZ US |
Postal Code: | 850863188 |
Phone Number: | 6234281204 |
Fax Number: | 5203064877 |
NPI Enumeration Date: | 03/18/2016 |
NPI Last Update Date: | 03/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |