Individual
BRIAN CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
15921 N 91ST DR, PEORIA, AZ 85382
(623) 693-2198
Mailing address
6635 W HAPPY VALLEY RD STE A104, GLENDALE, AZ 85310-2609
(623) 693-2198
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
274984
AZ
Other
Enumeration date
06/07/2021
Last updated
03/02/2023
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