Individual
JOSEPHINE LICANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
719 S MOUNTAIN VIEW RD, APACHE JUNCTION, AZ 85219-7544
(480) 288-9814
Mailing address
719 S MOUNTAIN VIEW RD, APACHE JUNCTION, AZ 85219-7544
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN020825
AZ
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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