Individual
EDWARD SHANE TRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2109 NAVAJO BLVD, HOLBROOK, AZ 86025-1822
(928) 524-2851
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
219546
AZ
Other
Enumeration date
11/29/2018
Last updated
03/19/2021
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