Bain, Ilyssa

Bain, Ilyssa is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Bain, Ilyssa can be contacted via phone (602) 933-1900.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 933-1900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 259452 Arizona

Profile Details

NPI number 1588322770
LBN Legal business name Bain, Ilyssa
Credentials PNP-AC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2021
Last updated Feb 22nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588322770 NPPES
Arizona MEDICAID 120424

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