Provider Demographics
NPI:1154207090
Name:PFUND, NICOLE A
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:PFUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36305 N GANTZEL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7326
Mailing Address - Country:US
Mailing Address - Phone:480-331-6521
Mailing Address - Fax:480-420-3659
Practice Address - Street 1:10325 E RIGGS RD STE 105
Practice Address - Street 2:
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7646
Practice Address - Country:US
Practice Address - Phone:480-331-6521
Practice Address - Fax:480-420-3659
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA16474237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter