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:
Health care specialties
Specialty | Code | License # | 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 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1609862275 | NPPES |
Arizona | Other | 4435 | AZ LICENSE |
Arizona | MEDICAID | 927112 | AZ LICENSE |
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