Individual
MS. DALE ANN MANZOEILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4315 N MARYVALE PKWY, PHOENIX, AZ 85031-1942
(602) 243-7277
(623) 691-1770
Mailing address
2702 N 3RD ST STE 4020, SUITE 102, PHOENIX, AZ 85004-4608
(602) 323-3492
(602) 323-3399
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP2462
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11774490
CAQH
AZ
05
—
230765
—
AZ
Enumeration date
07/18/2007
Last updated
11/07/2016
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