Provider Demographics
NPI:1538981055
Name:HERMIZ, NARDIN (FNP-C)
Entity type:Individual
Prefix:
First Name:NARDIN
Middle Name:
Last Name:HERMIZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 W VILLA MARIA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1339
Mailing Address - Country:US
Mailing Address - Phone:224-678-8526
Mailing Address - Fax:
Practice Address - Street 1:16222 N 59TH AVE STE D170
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1708
Practice Address - Country:US
Practice Address - Phone:530-364-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ316059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily