Individual
MRS. GLORIA ANNETTE BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3864 N 27TH AVE, PHOENIX, AZ 85017-4703
(602) 685-6000
(602) 995-8503
Mailing address
3003 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-2914
(602) 685-6000
(602) 685-6002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP0298
AZ
364SF0001X
Family Health Clinical Nurse Specialist
RN063356
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151233
—
AZ
Enumeration date
12/29/2010
Last updated
04/14/2015
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