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PRIYA SABUMON BALAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4112 E WILDWOOD DR, PHOENIX, AZ 85048-8848
(302) 241-7082
Mailing address
6677 W THUNDERBIRD RD, STE I164, GLENDALE, AZ 85306-3762
(623) 878-2100

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN214133
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
271815
AZ

Other

Enumeration date
07/20/2021
Last updated
04/05/2022
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