Individual
KARIE LYNN FEDORICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2915 E BASELINE RD STE 101, GILBERT, AZ 85234-2427
(480) 776-0626
(480) 776-0627
Mailing address
4545 E CHANDLER BLVD STE 206, PHOENIX, AZ 85048-7645
(480) 961-5956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2779
AZ
363AM0700X
Medical Physician Assistant
Primary
2779
AZ
Other
Enumeration date
12/13/2006
Last updated
04/12/2023
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