Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN082443 | AZ |
NPI | 1023267051 |
---|---|
Provider Name | Patricia Ann Faust |
First Address | Scottsdale, AZ 85258-4583 |
Second Address | Tempe, AZ 85283-3268 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 03/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P85105 | (02) | AZ |