Individual
ABBRA LEE JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9832 E RED GIANT DR, MESA, AZ 85212-8997
(310) 954-6514
Mailing address
9832 E RED GIANT DR, MESA, AZ 85212-8997
(310) 954-6514
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP054611
AZ
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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