| NPI | 1295111987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA PRENDERGAST Director 480-220-4688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ RN039088) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |