Individual
LAURA PATRICIA BLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8449 W ROSS AVE, PEORIA, AZ 85382-7424
(928) 231-2662
Mailing address
8449 W ROSS AVE, PEORIA, AZ 85382-7424
(928) 231-2662
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
166696
AZ
163WS0200X
School Registered Nurse
Primary
166696
AZ
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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