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Individual

BONNIE GANCE-CLEVELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
500 NORTH 3RD ST, SUITE 155, PHOENIX, AZ 85004-0698
(602) 496-0721
Mailing address
500 N 3RD ST, MAILCODE 3020, PHOENIX, AZ 85004-2135
(602) 496-0908
(602) 496-0986

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN139505
AZ
363LP0200X
Pediatric Nurse Practitioner
Primary
AP3039
AZ

Other

Enumeration date
05/13/2010
Last updated
05/13/2010
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