Basic Information
| Provider Information | |||||||||
| NPI: | 1801418249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIARELLI | ||||||||
| FirstName: | NICOLA | ||||||||
| MiddleName: | PALMER | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16430 N SCOTTSDALE RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852541581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022667000 | ||||||||
| FaxNumber: | 6026468901 | ||||||||
| Practice Location | |||||||||
| Address1: | 7400 S POWER RD STE 126 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852979283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804827350 | ||||||||
| FaxNumber: | 4804827370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2020 | ||||||||
| LastUpdateDate: | 09/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 241004 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 207Q00000X | 241004 | AZ | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.