Basic Information
| Provider Information | |||||||||
| NPI: | 1376070508 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CENTORINO | ||||||||
| FirstName: | LIGITA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 W ENCANTO BLVD UNIT B304 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850031135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024343031 | ||||||||
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| Practice Location | |||||||||
| Address1: | 755 E MCDOWELL RD # 4 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025213090 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2017 | ||||||||
| LastUpdateDate: | 05/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP10084 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.