Healthcare Provider Details

I. General information

NPI: 1346989514
Provider Name (Legal Business Name): MRS. HALEY ANN FERRALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 W GLENDALE AVE
GLENDALE AZ
85303-2611
US

IV. Provider business mailing address

6975 W GLENDALE AVE
GLENDALE AZ
85303-2611
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax: 602-243-1235
Mailing address:
  • Phone: 602-243-7277
  • Fax: 602-243-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number9386
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: