Individual
MRS. LEILANI THERESA MCGLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1850 N CENTRAL AVE, SUITE 1600, PHOENIX, AZ 85004-4527
(602) 262-8900
(602) 262-8890
Mailing address
1850 N CENTRAL AVE, SUITE 1600, PHOENIX, AZ 85004-4527
(602) 262-8900
(602) 262-8890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
217746
NC
207Q00000X
Family Medicine Physician
15068
TN
363L00000X
Nurse Practitioner
Primary
AP7473
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15068
LICENSE
TN
05
—
1527578
—
TN
01
—
1679839492
MEDICARE GROUP NPI
—
Enumeration date
12/15/2007
Last updated
11/02/2017
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