Individual
DR. SUE BAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15002 N 32ND ST, PHOENIX, AZ 85032-4441
(602) 449-2035
Mailing address
15002 N 32ND ST, PHOENIX, AZ 85032-4441
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN074556
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
629199
—
AZ
Enumeration date
05/14/2009
Last updated
05/14/2009
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