| NPI | 1255283065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALAR KUPPAN Owner/Provider/Member/Admin 623-261-5258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2026-02-12 |
| Last Update Date | 2026-02-12 |