Healthcare Provider Details

I. General information

NPI: 1760202808
Provider Name (Legal Business Name): PATRICIA LOUISE DRURY RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 W 18TH ST
TEMPE AZ
85281-6213
US

IV. Provider business mailing address

1326 W 18TH ST
TEMPE AZ
85281-6213
US

V. Phone/Fax

Practice location:
  • Phone: 480-966-9934
  • Fax:
Mailing address:
  • Phone: 480-966-9934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN210347
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: