Individual
BRYAN GAITANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
19137 E KINGBIRD DR, QUEEN CREEK, AZ 85142-5329
(770) 256-2775
Mailing address
19137 E KINGBIRD DR, QUEEN CREEK, AZ 85142-5329
(770) 256-2775
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
223457
AZ
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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