Provider Demographics
NPI:1487326757
Name:CARRANZA, NANCY MARIE (DPT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N 91ST AVE STE 104B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4051
Mailing Address - Country:US
Mailing Address - Phone:623-565-0235
Mailing Address - Fax:
Practice Address - Street 1:1805 N 91ST AVE STE 104B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4051
Practice Address - Country:US
Practice Address - Phone:623-565-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty