Individual
AMANDA GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16928 W BELL RD, SUITE 701, SURPRISE, AZ 85374-8948
(623) 580-0026
Mailing address
16928 W BELL RD, SUITE 701, SURPRISE, AZ 85374-8948
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5707
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
912242
—
AZ
Enumeration date
04/17/2014
Last updated
06/17/2014
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