| NPI | 1043529944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE PETERSON Supervisor, Provider Enrollment 480-862-1677 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2021-11-10 |