| NPI | 1114341237 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JEANNETTE MARTINEZ Office Manager 480-347-0310 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP2677) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP0322) | 
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4859) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ F0513130) | |
| Enumeration Date | 2014-02-10 | 
| Last Update Date | 2014-02-10 |