Individual
DIANA VERONICA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15182 N 75TH AVE STE 180, PEORIA, AZ 85381-4722
(602) 567-7856
Mailing address
15977 W WESTVIEW DR, GOODYEAR, AZ 85395-7756
(623) 533-1063
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023064248
AZ
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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