Organization
VIRGINIA PRENDERGAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA PRENDERGAST (DIRECTOR)
(480) 220-4688
Entity
Organization
Contact information
Practice address
1424 E MARSHALL AVE, PHOENIX, AZ 85014-2358
(480) 220-4688
(602) 406-4969
Mailing address
1424 E MARSHALL AVE, PHOENIX, AZ 85014-2358
(480) 220-4688
(602) 406-4969
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN039088
AZ
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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