| NPI | 1003270596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA RENEE GREEN Credentialing Specialist 623-277-1130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP8558) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-06-16 |