| Az Wound Solutions, PLLC | |
|
15396 N 83rd Ave Ste F101 Peoria AZ 85381-5629 | |
| (602) 978-5000 | |
| (602) 978-0734 |
| Full Name | Az Wound Solutions, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 15396 N 83rd Ave Ste F101, Peoria, Arizona |
| Authorized Official Name and Position | Kelley Jean Darnell (ADMINISTRATOR) |
| Authorized Official Contact | 6233634157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Wound Solutions, PLLC 15396 N 83rd Ave Ste F101 Peoria AZ 85381-5629 Ph: (602) 978-5000 | Az Wound Solutions, PLLC 15396 N 83rd Ave Ste F101 Peoria AZ 85381-5629 Ph: (602) 978-5000 |
| NPI Number | 1447909171 |
|---|---|
| Provider Enumeration Date | 03/21/2022 |
| Last Update Date | 07/16/2026 |
| Certification Date | 07/16/2026 |
| Medicare PECOS PAC ID | 5991192874 |
|---|---|
| Medicare Enrollment ID | O20220422001566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447909171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Joshua D Holland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922071232 PECOS PAC ID: 6507861564 Enrollment ID: I20080401000828 |
| Provider Name | Alicia Ann Kohls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881262780 PECOS PAC ID: 3779985197 Enrollment ID: I20210708000313 |
| Provider Name | Mary Elizabeth Tyndall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376250092 PECOS PAC ID: 8921471830 Enrollment ID: I20230223001581 |
| Provider Name | Amanda Paige Gunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700398716 PECOS PAC ID: 8123480530 Enrollment ID: I20230817000692 |
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