Individual
ALICE MUSTAPHA AMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
9250 W THOMAS RD, SUITE 200, PHOENIX, AZ 85037-3382
(623) 516-8252
(623) 516-8253
Mailing address
105 PROFESSIONAL PARK DR, CUMMING, GA 30040-2381
(623) 241-6152
(623) 241-6152
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN229290
GA
363LA2100X
Acute Care Nurse Practitioner
AP4289
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687467
—
AZ
01
—
Z71338
MEDICARE PTAN
AZ
Enumeration date
01/17/2012
Last updated
11/29/2023
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