Individual
ZONA BLACK CALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HWY 163, BLDG KA-2010, KAYENTA, AZ 86033
(928) 679-4100
(928) 679-4029
Mailing address
PO BOX 632, TONALEA, AZ 86044
(928) 679-4100
(928) 679-4029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN073269
AZ
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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