Individual provider · Type 1 NPI

Ilyssa Bain, PNP-AC

Pediatric Nurse Practitioner · Phoenix, AZ

NPI number 1588322770 Active

Practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-7761

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X259452 (AZ)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1588322770

Ilyssa Bain, PNP-AC's National Provider Identifier is 1588322770, issued on Dec 4, 2021. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 22, 2024.