NPI | 1154856474 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLI L CASADY Member 480-462-2950 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
Enumeration Date | 2017-04-24 |
Last Update Date | 2018-06-05 |