Provider Demographics
NPI:1023171840
Name:PALENCIA, MERLE NUNEZ (NP)
Entity type:Individual
Prefix:
First Name:MERLE
Middle Name:NUNEZ
Last Name:PALENCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9453 W TONOPAH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-5342
Mailing Address - Country:US
Mailing Address - Phone:623-825-2981
Mailing Address - Fax:
Practice Address - Street 1:3141 N 3RD AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4351
Practice Address - Country:US
Practice Address - Phone:602-745-7943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN104810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner