Country Clinic Pc

LBN: Country Clinic Pc
Country Clinic Pc is an health care organization with primary practice located at 26416 S Mandarin Dr , Queen Creek AZ 85142-9411. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. Country Clinic Pc can be contacted via phone (480) 369-0582, or through Hakeman, Katherine C via phone (480) 369-0582.

Contact Information

Primary practice address
26416 S Mandarin Dr Queen Creek AZ 85142-9411
Phone: (480) 369-0582
Fax: (480) 279-4274
Website:
Map and Directions
Authorized official contact:
Name: Hakeman, Katherine C Nurse Practitioner (NP)
Phone: (480) 369-0582

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP2088 Arizona

Profile Details

NPI number 1740561562
LBN Legal business name Country Clinic Pc
DBA Doing business as
Authorized official Hakeman, Katherine C Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 7th, 2011
Last updated Mar 14th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740561562 NPPES
Arizona MEDICAID 644363

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