NPI 1720071608
United States Air Force
Practice location
- Address
- 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529
- Phone
- (623) 856-9725
- Fax
- (623) 856-7567
- Mailing address
- 2407 N 127th Ln, Avondale, AZ 85323-6576
Authorised official
- Name
- Patti Jo Peterson-Balliet
- Title
- Pediatric Nurse Practitioner
- Phone
- (626) 536-4774
Registered specialties
Military Hospital
Primary
Registry record
- NPI
- 1720071608
- Entity type
- Organization
- NPI issued
- 25 Aug 2005
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.