Individual
TAKISHA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7542 W CINNABAR AVE, PEORIA, AZ 85345-6773
(402) 415-4777
Mailing address
7542 W CINNABAR AVE, PEORIA, AZ 85345-6773
(402) 415-4777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19716
NE
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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