Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP2686 | AZ |
NPI | 1023222551 |
---|---|
Provider Name | Mary L Froehlich |
First Address | Phoenix, AZ 85016-4411 |
Second Address | Phoenix, AZ 85016-4411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 30/07/2017 |