Most Relevant Information
Provider Data
| NPI Number: | 1003359696 |
| Provider Name: | TAMMY MIRKAZEMI |
| Entity Type: | Individual |
| Taxonomy Code: | 376G00000X |
| Specialty: | Nursing Home Administrator |
| License Number: | BH4966 |
Most Important Dates
| Enumeration Date: | 11/30/2016 |
| Last Updated: | 11/30/2016 |
Provider Practice Location
13039 W CHEERY LYNN RD
AVONDALE
AZ
853926775
Practice Location Phone/Fax
| Phone: | 6233267137 |
| Fax: |
Provider Mailing Location
13039 W CHEERY LYNN RD
AVONDALE
AZ
853926775
Provider Mailing Phone/Fax
| Phone: | 6233267137 |
| Fax: |