Individual
ELLEN CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3141 N 3RD AVE, AZ9501000, PHOENIX, AZ 85013-4351
(602) 745-7925
Mailing address
819 W LODGE DR, TEMPE, AZ 85283-3570
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN-044483
AZ
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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