Individual
DAMARIS TEARA OLIPHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4502 S HARDY DR, TEMPE, AZ 85282-6560
(414) 388-9955
Mailing address
4502 S HARDY DR, TEMPE, AZ 85282-6560
(414) 388-9955
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326002
WI
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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