Individual
MARIBEL MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2811
(602) 433-1200
Mailing address
10165 E ISLETA AVE, MESA, AZ 85209-7775
(480) 357-8503
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP045028
AZ
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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