Organization
MARICOPA SURGICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN ELIZABETH TYRRELL NP (PRESIDENT)
(602) 616-0123
Entity
Organization
Contact information
Practice address
8314 N 49TH DR, GLENDALE, AZ 85302-6307
(602) 616-0123
(623) 847-1140
Mailing address
8314 N 49TH DR, GLENDALE, AZ 85302-6307
(602) 616-0123
(623) 847-1140
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN043432
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
574237
—
AZ
Enumeration date
06/01/2007
Last updated
08/22/2020
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