Organization
SJ MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMMACULATA INYANG DNP (PROVIDER)
(602) 753-0667
Entity
Organization
Contact information
Practice address
4622 N 35TH AVE, PHOENIX, AZ 85017-3403
(602) 753-0667
(602) 441-2202
Mailing address
4622 N 35TH AVE, PHOENIX, AZ 85017-3403
(602) 753-0667
(602) 441-2202
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP7650
AZ
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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