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NPI Code Detail

MEDICARE: MRS. KIEUANH T PHAM R.N.

MEDICARE:  MRS. KIEUANH T PHAM  R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered NurseRN129491AZ

General Provider Information

NPI Number : 1912027509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIEUANH T PHAM R.N.
Provider Business Mailing Address
First Line : 7734 W MCRAE WAY
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-5917
Country : US
Telephone Number : 623-215-4804
Fax Number :
Provider Business Practice Location Address
First Line : 20012 N 35TH AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-2204
Country : US
Telephone Number : 623-445-4110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. KIEUANH T PHAM R.N.” Practice Location

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