| NPI | 1508630781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN CAROLINE MACDONALD Medical Director 480-915-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2024-05-06 |