Individual
LEIA KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21180 N 87TH AVE, PEORIA, AZ 85382-6497
(623) 412-5229
Mailing address
21180 N 87TH AVE, PEORIA, AZ 85382-6497
(623) 412-5229
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN129849
AZ
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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