Individual
MICKENSI PAGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
8410 W THOMAS RD STE 134, PHOENIX, AZ 85037-3374
(623) 907-2377
(480) 857-2667
Mailing address
PO BOX 6730, CHANDLER, AZ 85246-6730
(480) 821-3600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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