Individual
EDWINA QUACHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
127 N. MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2690
Mailing address
PO BOX 600, 127 N. MAIN, TUBA CITY, AZ 86045-0600
(928) 283-2690
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP006626
AZ
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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