Individual
DIANE LYNNETTE PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP C
Contact information
Practice address
500 N 3RD ST, SUITE 155, PHOENIX, AZ 85004-2135
(602) 496-0721
(602) 496-0675
Mailing address
500 N 3RD ST, SUITE 155, PHOENIX, AZ 85004-2135
(602) 496-0721
(602) 496-0675
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP2706
AZ
363LF0000X
Family Nurse Practitioner
AP2709
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z125057
PTAN MEDICARE
AZ
Enumeration date
10/10/2007
Last updated
09/12/2012
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