Organization
DESERT GRACE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA P HALL NURSE PRACTITIONER (SOLE MEMBER)
(951) 764-2457
Entity
Organization
Contact information
Practice address
17328 W SELDON LN, WADDELL, AZ 85355-7628
(951) 764-2457
Mailing address
PO BOX 774, WADDELL, AZ 85355-0774
(951) 764-2457
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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