Individual
MARY LOU ALECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2601 E ROOSEVELT ST, DEPARTMENT OF PEDIATRICS, PHOENIX, AZ 85008-4973
(602) 344-5418
(602) 344-5859
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
039615
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445868
—
AZ
Enumeration date
09/27/2006
Last updated
06/18/2009
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