Individual
AMANDA KATHERINE RADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10251 N 35TH AVE, PHOENIX, AZ 85051-1305
(602) 995-7366
Mailing address
10251 N 35TH AVE, PHOENIX, AZ 85051-1305
(602) 995-7366
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
147222
AZ
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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