Individual
JUDITH EKBLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
10815 W MCDOWELL RD STE 304, AVONDALE, AZ 85392-5016
(623) 251-7559
Mailing address
3815 E BELL RD STE 2200, PHOENIX, AZ 85032-2139
(602) 633-3848
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10170
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278816
—
AZ
01
—
Z205037
MEDICAID
AZ
Enumeration date
05/30/2017
Last updated
07/21/2022
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