Individual
DEREK SEBADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANPC
Contact information
Practice address
20040 N 19TH AVE, SUITE A, PHOENIX, AZ 85027-4255
(623) 869-5000
(623) 869-0927
Mailing address
20040 N 19TH AVE, SUITE A, PHOENIX, AZ 85027-4255
(623) 869-5000
(623) 869-0927
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN082334
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61944
—
AZ
Enumeration date
08/04/2005
Last updated
12/21/2012
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