Provider Demographics
NPI:1831473404
Name:PRICE, ALICIA N (LPN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:N
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44150 W MARICOPA CASA GRANDE HWY
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-5900
Mailing Address - Country:US
Mailing Address - Phone:520-568-7100
Mailing Address - Fax:520-568-7104
Practice Address - Street 1:44150 W MARICOPA CASA GRANDE HWY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-5900
Practice Address - Country:US
Practice Address - Phone:520-568-7100
Practice Address - Fax:520-568-7104
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP04770164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse