Individual
MS. REBECCA M. LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
14973 W BELL RD, SURPRISE, AZ 85374-3236
(623) 934-5600
(623) 934-5603
Mailing address
PO BOX 47090, PHOENIX, AZ 85068-7090
(623) 934-5600
(623) 934-5603
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP1554
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
746547
—
AZ
Enumeration date
01/14/2007
Last updated
03/01/2013
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