Individual
ARACELI LABASTIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6036 N 19TH AVE, PHOENIX, AZ 85015-2106
(602) 246-7462
Mailing address
13225 N 20TH AVE, PHOENIX, AZ 85029-1603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10973
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP10973
ARIZONA STATE BOARD LICENSE
AZ
Enumeration date
03/13/2018
Last updated
03/13/2018
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