Healthcare Provider Details

I. General information

NPI: 1174073035
Provider Name (Legal Business Name): ALVERNA HESS MPAS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALVERNA HESS BUGH

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 10/21/2023
Certification Date: 10/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 E SOUTHERN AVE STE D
TEMPE AZ
85282-7511
US

IV. Provider business mailing address

2034 E SOUTHERN AVE STE D
TEMPE AZ
85282-7511
US

V. Phone/Fax

Practice location:
  • Phone: 480-923-6200
  • Fax: 602-419-3101
Mailing address:
  • Phone: 480-923-6200
  • Fax: 602-419-3101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.004863RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number9261
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9261
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: