Provider Demographics
NPI:1760097570
Name:PARTLOW, JUSTIN THOMAS (MSN AGACNP-BC APRN)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:THOMAS
Last Name:PARTLOW
Suffix:
Gender:M
Credentials:MSN AGACNP-BC APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3124 E BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-7109
Mailing Address - Country:US
Mailing Address - Phone:602-790-8029
Mailing Address - Fax:602-842-4094
Practice Address - Street 1:3124 E BLOOMFIELD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-7109
Practice Address - Country:US
Practice Address - Phone:602-790-8029
Practice Address - Fax:602-842-4094
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2025-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ247337363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care