# R&N FAMILY MEDICAL PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maryvale Family Practice Group Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437661212
- **Authorized official:** NAHLA CHIRCO FNP (FNP)
- **Authorized official phone:** (248) 250-3146

## Contact information

- **Practice address:** 4700 N 51ST AVE, PHOENIX, AZ 85031-1237
- **Practice address phone:** (623) 209-5555
- **Practice address fax:** (623) 247-1905
- **Mailing address:** 4700 N 51ST AVE, PHOENIX, AZ 85031-1237
- **Mailing address phone:** (623) 209-5555
- **Mailing address fax:** (623) 247-1905

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2017
- **Last updated:** 11/01/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1750518395 | NPI | MI |