NORTHERN ARIZONA HEALTHCARE CORPORATION NPI 1639545007

NPI Information

NPI: 1639545007
Provider Name: NORTHERN ARIZONA HEALTHCARE CORPORATION
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 03D2198809

Address:
1200 N BEAVER ST
FLAGSTAFF, AZ
ZIP 86001
Phone: (928) 779-3366
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NORTHERN ARIZONA HEALTHCARE CORPORATION is a pediatrics nurse practitioner in Flagstaff, AZ. NORTHERN ARIZONA HEALTHCARE CORPORATION NPI is 1639545007. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 N BEAVER ST
FLAGSTAFF, AZ
ZIP 86001-118
Phone: (928) 779-3366

The provider's authorized official is Colleen Little .
The authorized official title is Clinical Manager and has the following contact phone number (928) 779-3366.

The CLIA number assigned to this NPI record is 03D2198809 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2015 and was last updated on 8/19/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	AP8048	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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