Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 39353 | SC |
Y | 207YP0228X | Pediatric Otolaryngology | 46036 | AZ |
NPI | 1679865893 |
---|---|
Provider Name | Sharon Hughes Gnagi |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85006-1462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 18/12/2018 |