| Evernorth Care Providers - Arizona Pc | |
|
1420 5th Ave Ste 2200 Seattle WA 98101-1346 | |
| (773) 292-4800 | |
| (312) 564-4059 |
| Full Name | Evernorth Care Providers - Arizona Pc |
|---|---|
| Speciality | General Practice |
| Location | 1420 5th Ave Ste 2200, Seattle, Washington |
| Authorized Official Name and Position | Grace V Blue (CREDENTIALING SR. MANAGER) |
| Authorized Official Contact | 7732924800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evernorth Care Providers - Arizona Pc 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Arizona Pc 1420 5th Ave Ste 2200 Seattle WA 98101-1346 Ph: (773) 292-4800 |
| NPI Number | 1417731035 |
|---|---|
| Provider Enumeration Date | 08/23/2023 |
| Last Update Date | 03/27/2024 |
| Medicare PECOS PAC ID | 6002268455 |
|---|---|
| Medicare Enrollment ID | O20240122001335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417731035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Cheryl Hilton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184677742 PECOS PAC ID: 4082683651 Enrollment ID: I20240524003309 |
| Provider Name | Kerri Walton Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407311541 PECOS PAC ID: 9032443759 Enrollment ID: I20241022002095 |
| Provider Name | Ashley Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811328099 PECOS PAC ID: 8123257334 Enrollment ID: I20241120003892 |
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