Individual
MANDY KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1300 N 12TH ST, #518, PHOENIX, AZ 85006
(602) 257-9488
(602) 254-4258
Mailing address
2306 SWEET MEADOW RD, BALTIMORE, MD 21209-3866
(928) 412-0955
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R212273
MD
Other
Enumeration date
08/04/2006
Last updated
09/16/2015
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