NPI 1568218378

Detra L Vance

Practitioner Nursing Care Agency Phoenix, AZ

Practice location

Address: 1729 E Caldwell St, Phoenix, AZ 85042-8044
Phone: (602) 348-8278

Registered specialties

Nursing Care Agency Primary

Agencies Taxonomy 251J00000X Licence 999950215 (AZ)

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Registry record

NPI: 1568218378
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Apr 2024
Record last updated: 24 Apr 2024

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.