| Phoenix Health Practitioners Llc | |
|
4222 N 12th St Ste 200 Phoenix AZ 85014-6024 | |
| (602) 795-9223 | |
| (602) 795-9728 |
| Full Name | Phoenix Health Practitioners Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4222 N 12th St Ste 200, Phoenix, Arizona |
| Authorized Official Name and Position | Nehemiah Abuga (OWNER) |
| Authorized Official Contact | 4804505020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Health Practitioners Llc 12474 W Forest Pleasant Pl Peoria AZ 85383-5666 Ph: (602) 795-9223 | Phoenix Health Practitioners Llc 4222 N 12th St Ste 200 Phoenix AZ 85014-6024 Ph: (602) 795-9223 |
| NPI Number | 1205525839 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 05/03/2024 |
| Certification Date | 11/29/2023 |
| Medicare PECOS PAC ID | 9830552835 |
|---|---|
| Medicare Enrollment ID | O20230823003720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205525839 | NPI | - | NPPES |
| Provider Name | Tirsa C Quartullo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467455477 PECOS PAC ID: 8022058692 Enrollment ID: I20050504000021 |
| Provider Name | Caroline Bitutu Nyakweba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407334303 PECOS PAC ID: 7416209077 Enrollment ID: I20181009001986 |
| Provider Name | Eric Mosokobe Ogari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316420631 PECOS PAC ID: 6204171218 Enrollment ID: I20181219003046 |
| Provider Name | Symonpeter Ndungu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053914564 PECOS PAC ID: 0345652004 Enrollment ID: I20201222001422 |
| Provider Name | Caroline N Ombuna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902558893 PECOS PAC ID: 9335533157 Enrollment ID: I20220221002339 |
| Provider Name | Alice Nduku Mwanza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982390167 PECOS PAC ID: 2668829383 Enrollment ID: I20231116002949 |
| Provider Name | Jaimie Lukose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457129819 PECOS PAC ID: 9436592003 Enrollment ID: I20240210000697 |
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