| Mishaun Pllc | |
|
3640 Highway 95 Ste 100 Bullhead City AZ 86442-4336 | |
| (702) 339-7688 | |
| Not Available |
| Full Name | Mishaun Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3640 Highway 95 Ste 100, Bullhead City, Arizona |
| Authorized Official Name and Position | Mishaun Frances Newman (OWNER) |
| Authorized Official Contact | 7023397688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mishaun Pllc 2865 Grandhill Rd Bullhead City AZ 86442-8512 Ph: (702) 339-7688 | Mishaun Pllc 3640 Highway 95 Ste 100 Bullhead City AZ 86442-4336 Ph: (702) 339-7688 |
| NPI Number | 1356038053 |
|---|---|
| Provider Enumeration Date | 04/21/2023 |
| Last Update Date | 04/21/2023 |
| Medicare PECOS PAC ID | 3971960782 |
|---|---|
| Medicare Enrollment ID | O20230801003919 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356038053 | NPI | - | NPPES |
| 1174897557 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mishaun F Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174897557 PECOS PAC ID: 3779895321 Enrollment ID: I20150709003086 |
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