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Organization
PHOENIX INDIAN MEDICAL CENTER
Active
Organization
PHOENIX INDIAN MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN J. LOPEZ REGISTERED NURSE (PUBLIC HEALTH NURSE)
(602) 248-4194
Entity
Organization
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 248-4194
(602) 200-5381
Mailing address
1244 E BETHANY HOME RD, 36-A, PHOENIX, AZ 85014-2043
(602) 266-2281
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN051810
AZ
Other
Enumeration date
01/22/2007
Last updated
08/22/2020
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