Individual
THERESA K BARRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
HWY 264, MPP 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
PO BOX 113, KEAMS CANYON, AZ 86034-0113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2869452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
02/28/2019
Last updated
02/28/2019
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