Individual
TAMMY MIRKAZEMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13039 W CHEERY LYNN RD, AVONDALE, AZ 85392-6775
(623) 326-7137
Mailing address
13039 W CHEERY LYNN RD, AVONDALE, AZ 85392-6775
(623) 326-7137
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
BH4966
AZ
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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