| Family Nurse Practice P.l.l.c. | |
|
1727 W Emelita Ave Apt 2104 Mesa AZ 85202-3168 | |
| (480) 553-1547 | |
| (480) 615-9039 |
| Full Name | Family Nurse Practice P.l.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1727 W Emelita Ave Apt 2104, Mesa, Arizona |
| Authorized Official Name and Position | Gary Rayburn (OWNER) |
| Authorized Official Contact | 4805531547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Nurse Practice P.l.l.c. 1727 W Emelita Ave Apt 2104 Mesa AZ 85202-3168 Ph: (480) 553-1547 | Family Nurse Practice P.l.l.c. 1727 W Emelita Ave Apt 2104 Mesa AZ 85202-3168 Ph: (480) 553-1547 |
| NPI Number | 1619606506 |
|---|---|
| Provider Enumeration Date | 06/07/2022 |
| Last Update Date | 06/10/2022 |
| Medicare PECOS PAC ID | 1951782572 |
|---|---|
| Medicare Enrollment ID | O20220713003969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619606506 | NPI | - | NPPES |
| Provider Name | Gary Michael Rayburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043965502 PECOS PAC ID: 2860873486 Enrollment ID: I20220714001085 |
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Cactus Pediatric Orthopaedics, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 S Dobson Rd Ste 200, Mesa, AZ 85202 Phone: 480-551-0300 | |
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