Individual
IDORENYIN PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1407 S 9TH AVE, PHOENIX, AZ 85007-3904
(602) 975-6155
Mailing address
9015 W UNION HILLS DR STE 107, #344, PEORIA, AZ 85382
(480) 256-2669
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
282721
AZ
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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