Individual
LELOOLE SOLE BARIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
103 MEDICINE WAY ROAD, PERIDOT, AZ 85542-0787
(928) 475-1400
Mailing address
PO BOX 787, PERIDOT, AZ 85542-0787
(928) 475-1274
(928) 475-7373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220610
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
546139
—
AZ
Enumeration date
06/30/2011
Last updated
10/17/2019
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