GLORIA JEAN EAGLE P.A.-C NPI 1770543506

NPI Information

NPI: 1770543506
Provider Name: GLORIA JEAN EAGLE, P.A.-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1200 W MOHAVE RD
PARKER, AZ
ZIP 85344
Phone: (928) 669-7380
Get Directions

Gloria Jean Eagle, P.A.-C is a medical physician assistant in Parker, AZ. Gloria Jean Eagle, P.A.-C NPI is 1770543506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1200 W MOHAVE RD
PARKER, AZ
ZIP 85344-349
Phone: (928) 669-7380
Fax: (928) 669-7371

The NPI 1770543506 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/24/2006 and was last updated on 7/5/2022.

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	363AM0700X	Physician Assistant	Medical	1932	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00279265	OTHER	ARIZONA	RAIL ROAD MEDICARE
2	158539	MEDICAID	ARIZONA
3	A20324620	OTHER	ARIZONA	BLUE CROSS BLUE SHEILD

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: 4/28/2024

NPI Synchronization or Removal

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