Organization · Type 2 NPI

Arizona State University

Family Nurse Practitioner · Glendale, AZ

NPI number 1255511465 Active

Practice location

4701 West Thunderbird Road, University Center Building, Room 190
Glendale, AZ 85306

Call (602) 543-8019 Map

Fax (602) 543-8079

Mailing address

PO Box 872104
Tempe, AZ 85287-2104

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XNone listed
Family Medicine Physician 207Q00000XNone listed
Family Nurse Practitioner 363LF0000XNone listed
Family Nurse Practitioner Primary 363LF0000XNone listed

Family Nurse Practitioner: Definition to come...

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About NPI 1255511465

Arizona State University's National Provider Identifier is 1255511465, issued on Nov 6, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Glendale, AZ. The record was last updated on Nov 3, 2014.