Individual
THERESA KE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2924 E FAIRMOUNT AVE APT 208, PHOENIX, AZ 85016-6943
(602) 663-8080
Mailing address
2924 E FAIRMOUNT AVE #208, PHOENIX, AZ 85016
(602) 663-8080
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP048207
AZ
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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