Individual
DEDRA A. WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10240 N 31ST AVE STE 200, PHOENIX, AZ 85051-9565
(602) 344-2500
(602) 247-9500
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5043
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TAP5036
AZ
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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