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General NPI Number Information
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NPI Number | 1295186518
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Entity Type | Organization
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Legal Business Name | SHIKOBA HEALING, LLC
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 9194 S WOOD CREEK LN
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City | TUCSON
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State | AZ
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Zip | 85756-6128
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Country | US
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Telephone | 520-349-7275
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Fax | 520-749-0053
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Provider Business Mailing Address
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Address Line | 9194 S WOOD CREEK LN
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City | TUCSON
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State | AZ
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Zip | 85756-6128
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Country | US
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Telephone | 520-349-7275
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Fax | 520-749-0053
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. PHYLLIS E. CLICK
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Credential | FNP
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Telephone | 520-349-7275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | AZ
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