Individual
DESIREE MUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 E NORTHERN AVE, PHOENIX, AZ 85020-4274
(602) 331-1470
Mailing address
22435 N 97TH LN, PEORIA, AZ 85383-4207
(623) 687-7708
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
284807
AZ
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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