Benvinda Ann Pereira, FNP | |
255 N. Central Blvd., Suite #5, Quartzsite, AZ 85346 | |
(928) 927-6105 | |
(928) 927-6110 |
Full Name | Benvinda Ann Pereira |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 255 N. Central Blvd., Quartzsite, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053421776 | NPI | - | NPPES |
641474 | Medicaid | AZ | |
Z164332 | Other | AZ | MEDICARE |
CG7880 | Other | AZ | MEDICARE RAILROAD GROUP |
AZ0147610 | Other | AZ | BCBS |
P00235241 | Other | AZ | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | RN115611 (Arizona) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP1431 (Arizona) | Primary |
Entity Name | La Paz Regional Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083639983 PECOS PAC ID: 1557273356 Enrollment ID: O20031219000694 |
Entity Name | La Paz Regional Hospital Inc |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1598038093 PECOS PAC ID: 1557273356 Enrollment ID: O20120409000479 |
Mailing Address | Practice Location Address |
---|---|
Benvinda Ann Pereira, FNP 3815 E Bell Rd Ste 2200, Phoenix, AZ 85032-2139 Ph: (602) 633-3838 | Benvinda Ann Pereira, FNP 255 N. Central Blvd., Suite #5, Quartzsite, AZ 85346 Ph: (928) 927-6105 |
Mr. Phillip Wayne Clark, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 150 E. Tyson Rd, Quartzsite, AZ 85359 Phone: 928-927-8749 Fax: 928-927-8748 |