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Individual

SHIRLEY ANN FURLONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
VN

Contact information

Practice address
ALHAMBRA SCHOOL DISTRICT NO 68, 4510 N 37TH AVENUE, PHOENIX, AZ 85019
(602) 336-2990
(602) 336-2271
Mailing address
ALHAMBRA SCHOOL DISTRICT NO 68, 4510 N 37TH AVENUE, PHOENIX, AZ 85019
(602) 336-2990
(602) 336-2271

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN054782
AZ
164X00000X
Licensed Vocational Nurse
693674
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1093938441
AHCCCS
AZ
01
86-6000510
AHCCCS ADMINISTRATOR COUNTY OF MARICOPA ALHAMBRA SCHOOL DISTRICT NO 68
AZ
Enumeration date
10/25/2017
Last updated
01/24/2019
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