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Contact Information

SAN CARLOS APACHE HEALTHCARE CORPORATION
103 MEDICINE WAY ROAD
PERIDOT, AZ85542
 Phone: 928-475-1200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SAN CARLOS APACHE HEALTHCARE CORPORATION · (Female)

NPI # 1801245501
Status Active
Credentials
Entity Individual
Enumeration date 06/03/2016
Last updated 06/03/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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