Individual
YVETTE THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
750 N ESTRELLA PKWY STE 60, GOODYEAR, AZ 85338-9279
(623) 321-5079
(623) 321-5083
Mailing address
750 N ESTRELLA PKWY STE 60, GOODYEAR, AZ 85338-9279
(623) 321-5079
(623) 321-5083
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1328
AZ
363L00000X
Nurse Practitioner
1328
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
933194
—
AZ
Enumeration date
07/21/2008
Last updated
02/09/2021
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