Advanced Wound Care Of Arizona Pllc | |
3667 Reflection Dr, Prescott, AZ 86305-7188 | |
(928) 530-3230 | |
Not Available |
Full Name | Advanced Wound Care Of Arizona Pllc |
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Type | Facility |
Speciality | Nurse Practitioner |
Location | 3667 Reflection Dr, Prescott, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1720839665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Ron A Olsen |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1972510675 PECOS PAC ID: 3577655398 Enrollment ID: I20110608000250 |
Provider Name | Sylvania H Hernandez-latog |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861881351 PECOS PAC ID: 5991020687 Enrollment ID: I20150223000928 |
Provider Name | Daniel Hall |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013437458 PECOS PAC ID: 7012288517 Enrollment ID: I20170801003861 |
Provider Name | Ashley Marie Eyer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013559301 PECOS PAC ID: 7517393374 Enrollment ID: I20200214001455 |
Provider Name | Amanda Paige Gunn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700398716 PECOS PAC ID: 8123480530 Enrollment ID: I20230817000692 |
Mailing Address | Practice Location Address |
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Advanced Wound Care Of Arizona Pllc Po Box 10634, Prescott, AZ 86304-0634 Ph: () - | Advanced Wound Care Of Arizona Pllc 3667 Reflection Dr, Prescott, AZ 86305-7188 Ph: (928) 530-3230 |