| NPI | 1649917535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA INGRAM Fnp 602-373-0932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2023-04-11 |