| NPI | 1306339049 |
|---|---|
| Former Legal Business Name | MOBILE PRACTITIONER |
| Entity Type | Organization |
| Authorized Contact | MEGAN HADEN Family Nurse Practitioner 602-740-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2019-07-12 |