Provider Demographics
NPI:1235509910
Name:ATENCIO, AUDREY (ACNP-BC)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:ATENCIO
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W 3RD ST STE 500
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2871
Mailing Address - Country:US
Mailing Address - Phone:480-237-5098
Mailing Address - Fax:877-358-8109
Practice Address - Street 1:51 W 3RD ST STE 500
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2871
Practice Address - Country:US
Practice Address - Phone:480-237-5098
Practice Address - Fax:877-358-8109
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8112364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care