Shurine Pate, Pllc | |
8300 N Lilly Bob Ln Prescott Valley AZ 86315-9803 | |
(806) 576-6947 | |
Not Available |
Full Name | Shurine Pate, Pllc |
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Speciality | Clinic/Center |
Location | 8300 N Lilly Bob Ln, Prescott Valley, Arizona |
Authorized Official Name and Position | Shurine Pate (OWNER) |
Authorized Official Contact | 8065766947 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Shurine Pate, Pllc 8300 N Lilly Bob Ln Prescott Valley AZ 86315-9803 Ph: (806) 576-6947 | Shurine Pate, Pllc 8300 N Lilly Bob Ln Prescott Valley AZ 86315-9803 Ph: (806) 576-6947 |
NPI Number | 1174243505 |
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Provider Enumeration Date | 08/29/2022 |
Last Update Date | 08/29/2022 |
Medicare PECOS PAC ID | 2365818291 |
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Medicare Enrollment ID | O20221018003186 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174243505 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Shurine Ann Pate |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235861832 PECOS PAC ID: 3274909106 Enrollment ID: I20221018003261 |
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