Boedigheimer, Maria Therese

Boedigheimer, Maria Therese is an individual health care provider with primary practice located at 3120 Clearwater Dr , Prescott AZ 86305-7131. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Boedigheimer, Maria Therese can be contacted via phone (928) 771-3704.

Contact Information

Primary practice address
3120 Clearwater Dr Prescott AZ 86305-7131
Phone: (928) 771-3704
Fax: (928) 771-0434
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 85000971 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4435 Arizona

Profile Details

NPI number 1609862275
LBN Legal business name Boedigheimer, Maria Therese
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Feb 10th, 2017 - about 8 years ago

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 1609862275 NPPES
Arizona Other 4435 AZ LICENSE
Arizona MEDICAID 927112 AZ LICENSE

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