MEDICARE: MARY ALICE QUIHUIS FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN049540	AZ

General Provider Information

NPI Number	:	1306978333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ALICE QUIHUIS FNP

Provider Business Mailing Address
First Line	:	11343 E ELMHURST DR
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-4506
Country	:	US
Telephone Number	:	480-802-0434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3960 E RIGGS RD STE 1
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-5411
Country	:	US
Telephone Number	:	807-864-4414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/12/2024

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