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NPI Code Detail

MEDICARE: MRS. LEANNE PARKER GUNDY NP

MEDICARE: MRS. LEANNE PARKER GUNDY NP
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
1363LW0102XWomen's Health Nurse PractitionerRN195909AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Z185028OTHERAZMEDICARE ID

General Provider Information

NPI Number : 1932109261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEANNE PARKER GUNDY NP
Provider Business Mailing Address
First Line : 599 E WILCOX DR
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85635-2531
Country : US
Telephone Number : 520-459-4604
Fax Number : 520-459-4603
Provider Business Practice Location Address
First Line : 599 E WILCOX DR
Second Line :
City : SIERRA VISTA
State : AZ
Zip : 85635-2531
Country : US
Telephone Number : 520-459-4604
Fax Number : 520-459-4603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/27/2016

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