Provider Demographics
NPI:1194995951
Name:HUSU, OTILIA E (PA)
Entity type:Individual
Prefix:
First Name:OTILIA
Middle Name:E
Last Name:HUSU
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:3030 N LITCHFIELD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7803
Mailing Address - Country:US
Mailing Address - Phone:623-882-3637
Mailing Address - Fax:623-536-0410
Practice Address - Street 1:3030 N LITCHFIELD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7803
Practice Address - Country:US
Practice Address - Phone:623-882-3637
Practice Address - Fax:623-536-0410
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2009-09-03
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Provider Licenses
StateLicense IDTaxonomies
AZ3720363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant