Individual
MILDRED HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
755 E MCDOWELL RD, PHOENIX, AZ 85006-2506
(602) 371-2964
Mailing address
755 E MCDOWELL RD, PHOENIX, AZ 85006-2506
(602) 371-2964
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN045974
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
491829
—
AZ
Enumeration date
01/25/2006
Last updated
07/08/2007
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