Individual
MEGAN MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25700 N 21ST AVE, PHOENIX, AZ 85085-8680
(623) 445-5810
Mailing address
25700 N 21ST AVE, PHOENIX, AZ 85085-8680
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
259498
AZ
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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