Individual
IVEY NICHOLS DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1631
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0001
(602) 263-1200
(602) 263-1631
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN093584
AZ
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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