NPI 1003359696

Tammy Mirkazemi

Practitioner Nursing Home Administrator Avondale, AZ

Practice location

Address: 13039 W Cheery Lynn Rd, Avondale, AZ 85392-6775
Phone: (623) 326-7137

Registered specialties

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X Licence BH4966 (AZ)

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Registry record

NPI: 1003359696
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Nov 2016
Record last updated: 30 Nov 2016

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.