Individual
MRS. CARLA JEAN ETHRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1016 N BURK ST, GILBERT, AZ 85234-3473
(480) 892-6908
(480) 813-8240
Mailing address
1055 S BUCHANAN ST, GILBERT, AZ 85233-8026
(480) 786-1825
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
RN064257
AZ
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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