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Individual

MRS. JOY MAE MENDENHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1619
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1619

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP0139
AZ
363LP0200X
Pediatric Nurse Practitioner
RN041430
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
463662
AZ
Enumeration date
11/06/2006
Last updated
07/09/2007
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