Provider Demographics
NPI:1144621913
Name:BIRD, IRENE ARCENAS (NP-C)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:ARCENAS
Last Name:BIRD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 CHARLOTTE PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1916
Mailing Address - Country:US
Mailing Address - Phone:704-936-5546
Mailing Address - Fax:833-973-5072
Practice Address - Street 1:3109 N 24TH ST STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7328
Practice Address - Country:US
Practice Address - Phone:602-839-3900
Practice Address - Fax:833-973-5072
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5185261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ977058Medicaid
AZZ195780Medicare Oscar/Certification