Individual
BENILDE MWISENEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13555 W MCDOWELL RD, GOODYEAR, AZ 85395-2624
(623) 295-1190
Mailing address
16064 W WILLIAMS ST, GOODYEAR, AZ 85338-3494
(623) 521-1416
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
304793
AZ
Other
Enumeration date
03/12/2024
Last updated
04/17/2024
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