Individual
VIRGINIA PRENDERGAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1424 E MARSHALL AVE, PHOENIX, AZ 85014-2358
(480) 220-4688
(602) 406-4969
Mailing address
1424 E MARSHALL AVE, PHOENIX, AZ 85014-2358
(480) 220-4688
(602) 406-4969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN039088
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP6877
AZ
Other
Enumeration date
11/08/2006
Last updated
11/03/2015
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