Healthcare Provider Details

I. General information

NPI: 1669394177
Provider Name (Legal Business Name): LAURA BROOKE COVEY EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E CENTER ST
CHINO VALLEY AZ
86323-7407
US

IV. Provider business mailing address

2851 ITHACA DR
PRESCOTT AZ
86301-7150
US

V. Phone/Fax

Practice location:
  • Phone: 928-583-5421
  • Fax:
Mailing address:
  • Phone: 928-458-8891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE4191298
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: