Individual
MANUEL ROMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5224 W DOVE CENTRE RD, MARANA, AZ 85658-5063
(520) 616-1445
(520) 616-1446
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
228421
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580457
—
AZ
Enumeration date
07/09/2019
Last updated
12/08/2021
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