| NPI | 1205509510 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WENDY BRYANT CEO 480-500-8065 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care | 
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory | 
| Enumeration Date | 2021-08-01 | 
| Last Update Date | 2025-08-18 |