Individual
MRS. LICEL TUMPAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
612 W BASELINE RD, MESA, AZ 85210-6041
(480) 834-9039
(480) 964-7802
Mailing address
2210 E LA COSTA DR, GILBERT, AZ 85298-9738
(480) 628-3066
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP10091
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP10091
AZ
Other
Enumeration date
08/31/2017
Last updated
10/20/2017
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