LICEETT PENA

MESA, AZ
NPI1740705961
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AZ  AP11544)
Additional Taxonomies163W00000X Registered Nurse
(Licence: AZ  RN182545)
Enumeration Date2017-08-09
Last Update Date2018-09-21
Business Address
LICEETT PENA FNP-C
616 E SOUTHERN AVE STE 103
MESA, AZ 85204
Phone number: 602-569-3999
Mailing Address
LICEETT PENA FNP-C
1533 E WILLETTA ST
PHOENIX, AZ 85006-2935
Phone number: 602-569-3999