| Corebella Health And Wellness Llc | |
|
2600 E Southern Ave Ste E1 Tempe AZ 85282-7744 | |
| (480) 542-4668 | |
| (877) 559-2816 |
| Full Name | Corebella Health And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 2600 E Southern Ave Ste E1, Tempe, Arizona |
| Authorized Official Name and Position | Andrea Kovall (VICE PRESIDENT OF MANAGED CARE) |
| Authorized Official Contact | 8335104357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corebella Health And Wellness Llc 2600 E Southern Ave Ste E1 Tempe AZ 85282-7744 Ph: (480) 542-8778 | Corebella Health And Wellness Llc 2600 E Southern Ave Ste E1 Tempe AZ 85282-7744 Ph: (480) 542-4668 |
| NPI Number | 1730553108 |
|---|---|
| Provider Enumeration Date | 11/21/2015 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/29/2022 |
| Medicare PECOS PAC ID | 9739597840 |
|---|---|
| Medicare Enrollment ID | O20210408002352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730553108 | NPI | - | NPPES |
| Provider Name | Mufid Khoury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396893335 PECOS PAC ID: 6901855055 Enrollment ID: I20050117000153 |
| Provider Name | Shawn M Mcgarvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568876480 PECOS PAC ID: 6709003536 Enrollment ID: I20140819000078 |
| Provider Name | Laura Wedebrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760818561 PECOS PAC ID: 9638398118 Enrollment ID: I20140915002722 |
| Provider Name | Marti M Manko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497259725 PECOS PAC ID: 0840547584 Enrollment ID: I20180726000272 |
| Provider Name | Rebecca Abiola Odede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750979936 PECOS PAC ID: 7214343565 Enrollment ID: I20210310002752 |
| Provider Name | Thomas Charles Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083981864 PECOS PAC ID: 9638556509 Enrollment ID: I20220513002164 |
| Provider Name | Audra Denise Ekeinde-jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295269884 PECOS PAC ID: 5698156057 Enrollment ID: I20220715001254 |
| Provider Name | Nancy Jo Alice Sutton-mcleod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912142290 PECOS PAC ID: 8022493980 Enrollment ID: I20220914001179 |
| Provider Name | Robert C Waller |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1326097809 PECOS PAC ID: 8628083946 Enrollment ID: I20230601001527 |
| Provider Name | Cheryl Mcclain |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1316965700 PECOS PAC ID: 9133026594 Enrollment ID: I20240112000479 |
| Provider Name | Rebecca Andrus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972217602 PECOS PAC ID: 0648623827 Enrollment ID: I20240124003937 |
| Provider Name | Catherine Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205313988 PECOS PAC ID: 4385983154 Enrollment ID: I20240215003061 |
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