Individual
AUDREY VERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP045817
AZ
164W00000X
Licensed Practical Nurse
PN5215182
FL
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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