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1245317502
SHANNON M KOVALCIK
PHOENIX, AZ
NPI
1245317502
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: AZ AP2427)
Enumeration Date
2006-11-01
Last Update Date
2007-07-08
Business Address
-- SHANNON M KOVALCIK NP
4840 E INDIAN SCHOOL RD STE 101
PHOENIX, AZ 85018-5500
Phone number: 602-224-6174
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Mailing Address
-- SHANNON M KOVALCIK NP
24431 N 38TH TER
GLENDALE, AZ 85310-3360
Phone number: 623-399-8717
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