St Elizabeths Health Center Inc | |
140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 | |
(520) 628-7871 | |
(520) 205-8461 |
Full Name | St Elizabeths Health Center Inc |
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Speciality | Clinic/Center |
Location | 140 W Speedway Blvd, Tucson, Arizona |
Authorized Official Name and Position | Mauricette Montredon (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5206287871 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St Elizabeths Health Center Inc 140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 Ph: (520) 628-7871 | St Elizabeths Health Center Inc 140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 Ph: (520) 628-7871 |
NPI Number | 1235560830 |
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Provider Enumeration Date | 12/06/2013 |
Last Update Date | 12/11/2019 |
Medicare PECOS PAC ID | 3072731397 |
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Medicare Enrollment ID | O20140828001967 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235560830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | OTC6842 (Arizona) | Primary |
Provider Name | Audrey I Russell Kibble |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164589974 PECOS PAC ID: 4082673371 Enrollment ID: I20041004000174 |
Provider Name | Maria E Johnston |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083693444 PECOS PAC ID: 6901841782 Enrollment ID: I20050622000685 |
Provider Name | Eileen M Mahony |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104981752 PECOS PAC ID: 8426074642 Enrollment ID: I20051018000267 |
Provider Name | Martha S Lizarraga De Garza |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366420648 PECOS PAC ID: 1759300890 Enrollment ID: I20051117000340 |
Provider Name | Klaus Appel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386725208 PECOS PAC ID: 1951409887 Enrollment ID: I20070531000183 |
Provider Name | Robert W Wood |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1497718332 PECOS PAC ID: 4880637339 Enrollment ID: I20080509000613 |
Provider Name | Angela Armenta |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992018980 PECOS PAC ID: 2365635620 Enrollment ID: I20101027000321 |
Provider Name | William H Lowe |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295094381 PECOS PAC ID: 6507088481 Enrollment ID: I20141107002096 |
Provider Name | Lisa H Kiser |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750538682 PECOS PAC ID: 6608943485 Enrollment ID: I20151007002224 |
Provider Name | Norma Magdaleno |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1386641124 PECOS PAC ID: 4981913647 Enrollment ID: I20151020000492 |
Provider Name | Desiderio Daniel Abeyta |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1124579701 PECOS PAC ID: 3173801842 Enrollment ID: I20161031002525 |
Provider Name | Lindsay Ann Bouchard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417480427 PECOS PAC ID: 4587924766 Enrollment ID: I20180208000481 |
Provider Name | Virginia Denise Ortiz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194010918 PECOS PAC ID: 4082965488 Enrollment ID: I20180925000843 |
Provider Name | Mylena Avalos Dominguez |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1861970337 PECOS PAC ID: 1355695487 Enrollment ID: I20191205001152 |
Provider Name | Marcela Quintero |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952966624 PECOS PAC ID: 1052744877 Enrollment ID: I20191210001195 |
Provider Name | Courtney Ann Rhoades |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679126262 PECOS PAC ID: 5496180846 Enrollment ID: I20200114000760 |
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