Faye Philomena Provenza MD

NPI 1053365247 - Emergency Medicine - 207P00000X

NPI Details
NPI 1053365247
Gender Female
Enumeration Date 05/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
110 S 9TH AVE
YAKIMA WA, 98902-3315, US
Phone (509) 575-5061
Fax
Business Location
12540 STILLWATER WAY
RENO NV, 89511-7780, US
Phone (502) 594-8462
Fax
Toxanomy
Taxonomy Code 207P00000X
License State Nevada
License Number 630
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According to our database, Dr. Faye Philomena Provenza MD NPI is 1053365247, taxonomy code is 207P00000X and license number is 630, license state is located at Nevada. Faye Philomena Provenza MD physically located at 110 S 9th Ave, Yakima WA, 98902-3315. NPI Number Faye Philomena Provenza MD has the Individual type.

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1053365247 NPI number is provided on an as is basis without warranty of any kind. 1053365247 is maintained by the National Plan & Provider Enumeration System. The contents of Faye Philomena Provenza MD are for informational purposes only.