Individual
DR. FAYE PHILOMENA PROVENZA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 S 9TH AVE, YAKIMA, WA 98902-3315
(509) 575-5061
Mailing address
12540 STILLWATER WAY, RENO, NV 89511-7780
(502) 594-8462
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
630
NV
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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