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Individual

RUTH MARIE AMUNDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
18887 N 71ST LN, GLENDALE, AZ 85308-5860
(602) 549-2029
(623) 412-4861
Mailing address
18887 N 71ST LN, GLENDALE, AZ 85308-5860
(602) 549-2029
(623) 412-4861

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP048386
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LP048386
AZ
Enumeration date
03/29/2019
Last updated
03/29/2019
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