Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP5093 | AZ |
NPI | 1033551585 |
---|---|
Provider Name | Dr. Nicole Leigh Frazier-Zaruba |
First Address | Phoenix, AZ 85006-2612 |
Second Address | Phoenix, AZ 85006-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2013 |
Last Update Date | 25/07/2013 |