Individual
DESTINY MEADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
(623) 237-4016
(623) 237-5615
Mailing address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP047061
AZ
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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