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General NPI Number Information
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NPI Number | 1982094819
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Entity Type | Organization
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Legal Business Name | PRIORITY HEALTH
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 3181 CLEARWATER DR SUITE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-7118
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Country | US
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Telephone | 928-515-1755
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 CLEARWATER DR SUITE B
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City | PRESCOTT
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State | AZ
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Zip | 86305-7118
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Country | US
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Telephone | 928-515-1755
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TERRY MAE BARNS
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Credential | NP
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Telephone | 928-499-8829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | AP2563
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License Number State | AZ
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