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Individual

IDRIS A IDRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
3515 W UNION HILLS DR STE 111, GLENDALE, AZ 85308-2430
(623) 328-8630
(623) 243-7842
Mailing address
3515 W UNION HILLS DR STE 111, GLENDALE, AZ 85308-2430
(623) 328-8630
(623) 243-7842

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F01190538
AZ

Other

Enumeration date
05/30/2019
Last updated
07/22/2019
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