Individual
AUDRA CORONA IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 E BASELINE RD STE 130, PHOENIX, AZ 85042-9629
(623) 251-7559
Mailing address
3317 S HIGLEY RD STE 114-157, GILBERT, AZ 85297-5443
(480) 203-6456
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
228643
AZ
Other
Enumeration date
08/15/2019
Last updated
01/06/2020
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