| Energie Health | |
|
1000 Willow Creek Rd Suite D Prescott AZ 86301-1645 | |
| (928) 458-7343 | |
| (928) 257-4422 |
| Full Name | Energie Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Willow Creek Rd, Prescott, Arizona |
| Authorized Official Name and Position | Susan Moore (OWNER) |
| Authorized Official Contact | 9284587343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Energie Health 1000 Willow Creek Rd Suite D Prescott AZ 86301-1645 Ph: (928) 458-7343 | Energie Health 1000 Willow Creek Rd Suite D Prescott AZ 86301-1645 Ph: (928) 458-7343 |
| NPI Number | 1528402039 |
|---|---|
| Provider Enumeration Date | 04/26/2013 |
| Last Update Date | 03/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528402039 | NPI | - | NPPES |
| 816045 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | AP3075 (Arizona) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | AP3075 (Arizona) | Secondary |
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