Individual
MANNAL J ABDALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RN, CSA
Contact information
Practice address
18402 N 14TH ST, PHOENIX, AZ 85022-1284
(361) 633-9838
Mailing address
18402 N 14TH ST, PHOENIX, AZ 85022-1284
(361) 633-9838
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
RN181727
AZ
363LF0000X
Family Nurse Practitioner
Primary
CNP230211
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-603
AMERICAN BOARD OF SURGICAL ASSISTANTS; SURGICAL FIRST ASSIST
AZ
Enumeration date
06/08/2018
Last updated
04/24/2024
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