Individual
AMANDA LEAH BISULCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6622 N 91ST AVE STE 100, GLENDALE, AZ 85305-2512
(623) 552-7147
Mailing address
140 S 108TH LN, AVONDALE, AZ 85323-3304
(716) 319-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
299192
AZ
163W00000X
Registered Nurse
592583
NY
Other
Enumeration date
11/08/2025
Last updated
11/08/2025
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