Individual
DIANA ANDREEA STAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18555 N 79TH AVE STE B108, GLENDALE, AZ 85308
(623) 773-2848
Mailing address
1847 W HEATHERBRAE DR, PHOENIX, AZ 85015-4764
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6630
AZ
Other
Enumeration date
02/07/2017
Last updated
07/17/2018
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