Basic Information
| Provider Information | |||||||||
| NPI: | 1316240377 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCARAMELLA | ||||||||
| FirstName: | MARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.N., FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7699 E PINNACLE PEAK RD STE 115 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852556322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803004663 | ||||||||
| FaxNumber: | 4803004888 | ||||||||
| Practice Location | |||||||||
| Address1: | 7699 E PINNACLE PEAK RD STE 115 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852556322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803004663 | ||||||||
| FaxNumber: | 4803004888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2010 | ||||||||
| LastUpdateDate: | 01/21/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WS0200X | RN053296 | AZ | Y | Nursing Service Providers | Registered Nurse | School |
No ID Information.