Organization
GOODYEAR FAMILY NURSE PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KESASI MARSH NP (OWNER)
(602) 541-5790
Entity
Organization
Contact information
Practice address
12725 W INDIAN SCHOOL RD STE E101, AVONDALE, AZ 85392-9525
(623) 471-9043
Mailing address
12725 W INDIAN SCHOOL RD # 101L-5, AVONDALE, AZ 85392-9520
(623) 471-9049
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
08/27/2025
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