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General NPI Number Information
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NPI Number | 1093499303
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Entity Type | Organization
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Legal Business Name | NORTHERN ARIZONA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1895 N JASPER DR STE 3
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1632
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Country | US
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Telephone | 928-913-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST ATTN: MANAGED CARE CONTRACTING
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6543
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ROBERT COFIELD
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Credential |
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Telephone | 28-773-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207YS0012X
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Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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