Individual
SUSANNA EMILIA NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3575 W DEER VALLEY RD, GLENDALE, AZ 85308-2002
(480) 585-5200
Mailing address
3575 W DEER VALLEY RD, GLENDALE, AZ 85308-2002
(480) 585-5200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9395
AZ
Other
Enumeration date
10/13/2022
Last updated
06/29/2024
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