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General NPI Number Information
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NPI Number | 1326786906
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Entity Type | Organization
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Legal Business Name | YAVAPAI FAMILY MEDICAL PLLC
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 7750 E FLORENTINE RD STE A
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2245
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Country | US
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Telephone | 928-277-1211
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Fax | 928-277-1239
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Provider Business Mailing Address
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Address Line | 7750 E FLORENTINE RD STE A
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2245
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Country | US
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Telephone | 928-277-1211
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Fax | 928-277-1239
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Authorized Official
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Title or Position | OWNER
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Name | LOUELLA BAUMAN
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Credential | NP
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Telephone | 928-277-1211
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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 |
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