Individual
MRS. WENDY KAYE POURBASTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
6950 E WILLIAMS FIELD RD, CARL T. HAYDEN VA MEDICAL CENTER, SOUTHEAST CLINIC, MESA, AZ 85212-6033
(602) 222-6568
(602) 222-6496
Mailing address
1120 E HEARNE WAY, GILBERT, AZ 85234-6018
(480) 497-9882
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN068727
AZ
Other
Enumeration date
06/17/2006
Last updated
05/02/2013
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