Individual
GRACE E HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2550 E GUADALUPE RD STE 115, GILBERT, AZ 85234-5114
(480) 632-1544
(480) 632-1533
Mailing address
6301 S MCCLINTOCK DR, SUITE 101, TEMPE, AZ 85283-3392
(480) 214-2300
(480) 214-2301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5787
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
965194
—
AZ
Enumeration date
09/10/2014
Last updated
07/08/2019
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