Individual
MR. GEORGE DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-3366
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
RN083316
AZ
Other
Enumeration date
08/25/2008
Last updated
11/19/2009
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