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NPI Code Detail

MEDICARE: CHRISTOPHER NOVACK NP-C

MEDICARE: CHRISTOPHER NOVACK NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP7913AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366825978
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER NOVACK NP-C
Provider Business Mailing Address
First Line : 1090 COMMERCE DR
Second Line :
City : PRESCOTT
State : AZ
Zip : 86305-3700
Country : US
Telephone Number : 928-583-1000
Fax Number : 866-812-1253
Provider Business Practice Location Address
First Line : 1090 COMMERCE DR
Second Line :
City : PRESCOTT
State : AZ
Zip : 86305-3700
Country : US
Telephone Number : 928-583-1000
Fax Number : 866-812-1253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2015
Last Update Date : 06/02/2026

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