Individual
HEIDI MARIE TAMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13823 N 21ST WAY, PHOENIX, AZ 85022-4648
(602) 257-3806
Mailing address
13215 N 18TH PL, PHOENIX, AZ 85022-5006
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP047410
AZ
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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