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Individual

MRS. ELIZABETH ANN PENFOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
740 E HIGHLAND AVE STE 101, PHOENIX, AZ 85014-3609
(602) 264-9044
(602) 264-0057
Mailing address
14155 N 83RD AVE, STE 110, PEORIA, AZ 85381-5640
(602) 264-9044
(602) 264-0057

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3730
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
506162
AZ
Enumeration date
01/02/2008
Last updated
05/24/2017
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