Individual
MS. MARILYNNE CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, PNP
Contact information
Practice address
1235 E HARMONT DR, PHOENIX, AZ 85020-3864
(602) 331-1470
(602) 678-5803
Mailing address
1235 E HARMONT DR, PHOENIX, AZ 85020-3864
(602) 331-1470
(602) 678-5803
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
16022426
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
851924
AHCCCS
AZ
Enumeration date
07/20/2007
Last updated
07/20/2007
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