Individual
MARY RENEE GOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
2202 N STOCKTON HILL RD STE 100, KINGMAN, AZ 86401-4622
(928) 681-8706
(928) 681-8707
Mailing address
1739 E BEVERLY AVE STE 204, KINGMAN, AZ 86409-3593
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP10182
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276876
—
AZ
Enumeration date
05/31/2017
Last updated
01/04/2022
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