| NPI | 1285183467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA O'BANNON Owner 480-699-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN 060080) |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-28 |