| NPI | 1114749033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE PINLAC Member/ Provider 602-699-4536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2025-01-10 |