Individual
MR. ERNEST MALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
14068 W HACKAMORE DR, SURPRISE, AZ 85387-1928
(847) 558-9908
Mailing address
14068 W HACKAMORE DR, SURPRISE, AZ 85387-1928
(847) 558-9908
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
243234
AZ
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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