| Mojave Complete Recovery PLLC | |
|
1010 E Mcdowell Rd Ste 410 Phoenix AZ 85006-2606 | |
| (719) 351-3586 | |
| Not Available |
| Full Name | Mojave Complete Recovery PLLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1010 E Mcdowell Rd Ste 410, Phoenix, Arizona |
| Authorized Official Name and Position | Erica Hargrave (OWNER) |
| Authorized Official Contact | 7193513586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mojave Complete Recovery PLLC 1891 E Sagittarius Pl Chandler AZ 85249-3753 Ph: (480) 788-3424 | Mojave Complete Recovery PLLC 1010 E Mcdowell Rd Ste 410 Phoenix AZ 85006-2606 Ph: (719) 351-3586 |
| NPI Number | 1336909241 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 10/03/2024 |
| Certification Date | 10/03/2024 |
| Medicare PECOS PAC ID | 1355830621 |
|---|---|
| Medicare Enrollment ID | O20251028000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336909241 | NPI | - | NPPES |
| Provider Name | Laura Wedebrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760818561 PECOS PAC ID: 9638398118 Enrollment ID: I20140915002722 |
| Provider Name | Nicki D Rippeteau |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235579749 PECOS PAC ID: 3476527961 Enrollment ID: I20171101000568 |
| Provider Name | Nilah Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518539550 PECOS PAC ID: 6103223516 Enrollment ID: I20210928003021 |
| Provider Name | Gina Pollina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396216289 PECOS PAC ID: 7618308248 Enrollment ID: I20220909002578 |
| Provider Name | Melinda Rose Claypool |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346679768 PECOS PAC ID: 7719115856 Enrollment ID: I20230918001503 |
| Provider Name | Camille Wilmsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487125175 PECOS PAC ID: 8224567938 Enrollment ID: I20260120002844 |
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