Individual
MS. ROBERTA M. VIDULICH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
PO BOX 5177, PHOENIX, AZ 85010-5177
(602) 344-5651
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN030478
AZ
Other
Enumeration date
11/18/2005
Last updated
07/08/2007
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