Provider Demographics
NPI:1548664600
Name:SVELTE LLC
Entity type:Organization
Organization Name:SVELTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:VARLEY
Authorized Official - Last Name:NYMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-400-3889
Mailing Address - Street 1:10201 S 51ST ST STE 220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5233
Mailing Address - Country:US
Mailing Address - Phone:602-374-6821
Mailing Address - Fax:480-207-6193
Practice Address - Street 1:10201 S 51ST ST STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5233
Practice Address - Country:US
Practice Address - Phone:602-374-6821
Practice Address - Fax:480-207-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty