Individual
IDA CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 486-6000
Mailing address
9315 W PONTIAC DR, PEORIA, AZ 85382-5164
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN131703
AZ
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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