MEDICARE: MARCIA C BIEHN C-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	363L00000X	Nurse Practitioner	RN027816	AZ

General Provider Information

NPI Number	:	1891969697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA C BIEHN C-FNP

Provider Business Mailing Address
First Line	:	1830 MESQUITE AVE
Second Line	:	STE A
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5885
Country	:	US
Telephone Number	:	928-855-8071
Fax Number	:	928-855-6869

Provider Business Practice Location Address
First Line	:	1830 MESQUITE AVE
Second Line	:	STE A
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5885
Country	:	US
Telephone Number	:	928-855-8071
Fax Number	:	928-855-6869

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

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	12/15/2010

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