Individual
KARISSA BUSTAMANTE COATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11851 N 51ST AVE STE B110, GLENDALE, AZ 85304-2823
(480) 882-4545
(623) 207-7410
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
(602) 490-0499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
06/23/2025
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