Individual
GINA DOREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15815 S LAKEWOOD PKWY W APT 1065, PHOENIX, AZ 85048-7289
(602) 491-1997
Mailing address
15815 S LAKEWOOD PKWY W APT 1065, PHOENIX, AZ 85048-7289
(602) 491-1997
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
338841
AZ
Other
Enumeration date
07/16/2026
Last updated
07/16/2026
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