| Thrive Healthcare Fnp Inc | |
|
1757 E Chestnut Blvd Lake Havasu City AZ 86404-8407 | |
| (270) 832-5930 | |
| Not Available |
| Full Name | Thrive Healthcare Fnp Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1757 E Chestnut Blvd, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Jennifer Lake King (NP-C) |
| Authorized Official Contact | 2708325930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Healthcare Fnp Inc 1757 E Chestnut Blvd Lake Havasu City AZ 86404-8407 Ph: (270) 832-5930 | Thrive Healthcare Fnp Inc 1757 E Chestnut Blvd Lake Havasu City AZ 86404-8407 Ph: (270) 832-5930 |
| NPI Number | 1225785462 |
|---|---|
| Provider Enumeration Date | 03/08/2022 |
| Last Update Date | 03/08/2022 |
| Medicare PECOS PAC ID | 2769878628 |
|---|---|
| Medicare Enrollment ID | O20220403000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225785462 | NPI | - | NPPES |
| 080555 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780294793 PECOS PAC ID: 2668890112 Enrollment ID: I20200915001939 |
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