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General NPI Number Information
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NPI Number | 1225702269
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Entity Type | Individual
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Provider Name | GAIL MARLA PRITIKIN FNP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 2840 N DYSART RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2338
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Country | US
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Telephone | 623-536-5309
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27792
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-0146
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Country | US
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Telephone | 480-352-4948
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 257126
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License Number State | AZ
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