Individual
NICOLE ELIZABETH ZACK NWOBODO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5605 W EUGIE AVE, STE. 200, GLENDALE, AZ 85304-1272
(602) 843-2991
(602) 978-1226
Mailing address
13965 N 75TH AVE, PEORIA, AZ 85381-6097
(602) 843-2991
(602) 978-1226
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10711
MN
363A00000X
Physician Assistant
Primary
5740
AZ
Other
Enumeration date
03/03/2010
Last updated
10/16/2017
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