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Individual

MONTY V HERRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
4909 E MCDOWELL RD, PHOENIX, AZ 85008-7735
(602) 685-6000
(602) 275-1355
Mailing address
3003 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-2902
(602) 685-6132
(602) 302-7925

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AP3503
AZ
363LF0000X
Family Nurse Practitioner
AP3503
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
491097
AZ
Enumeration date
01/07/2010
Last updated
08/25/2016
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