Individual
AMANDA M QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 546-1900
(602) 546-1918
Mailing address
1919 E THOMAS RD, BUILDING 2108, SUITE 101, PHOENIX, AZ 85016-7710
(602) 512-8030
(602) 512-8161
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3692
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321419
—
AZ
Enumeration date
09/27/2007
Last updated
01/11/2013
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