| St Elizabeths Health Center Inc | |
|
140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 | |
| (520) 628-7871 | |
| (520) 205-8461 |
| Full Name | St Elizabeths Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 140 W Speedway Blvd, Tucson, Arizona |
| Authorized Official Name and Position | Mauricette Montredon (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5206287871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Elizabeths Health Center Inc 140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 Ph: (520) 628-7871 | St Elizabeths Health Center Inc 140 W Speedway Blvd Suite #100 Tucson AZ 85705-7698 Ph: (520) 628-7871 |
| NPI Number | 1235560830 |
|---|---|
| Provider Enumeration Date | 12/06/2013 |
| Last Update Date | 12/11/2019 |
| Medicare PECOS PAC ID | 3072731397 |
|---|---|
| Medicare Enrollment ID | O20140828001967 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235560830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | OTC6842 (Arizona) | Primary |
| Provider Name | Audrey I Russell Kibble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164589974 PECOS PAC ID: 4082673371 Enrollment ID: I20041004000174 |
| Provider Name | Maria E Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083693444 PECOS PAC ID: 6901841782 Enrollment ID: I20050622000685 |
| Provider Name | James L Dumbauld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801906052 PECOS PAC ID: 4082630207 Enrollment ID: I20051018000242 |
| Provider Name | Eileen M Mahony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104981752 PECOS PAC ID: 8426074642 Enrollment ID: I20051018000267 |
| Provider Name | Martha S Lizarraga De Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366420648 PECOS PAC ID: 1759300890 Enrollment ID: I20051117000340 |
| Provider Name | Klaus Appel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386725208 PECOS PAC ID: 1951409887 Enrollment ID: I20070531000183 |
| Provider Name | Robert W Wood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497718332 PECOS PAC ID: 4880637339 Enrollment ID: I20080509000613 |
| Provider Name | Angela Armenta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992018980 PECOS PAC ID: 2365635620 Enrollment ID: I20101027000321 |
| Provider Name | William H Lowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295094381 PECOS PAC ID: 6507088481 Enrollment ID: I20141107002096 |
| Provider Name | Lisa H Kiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750538682 PECOS PAC ID: 6608943485 Enrollment ID: I20151007002224 |
| Provider Name | Norma Magdaleno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386641124 PECOS PAC ID: 4981913647 Enrollment ID: I20151020000492 |
| Provider Name | Desiderio Daniel Abeyta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124579701 PECOS PAC ID: 3173801842 Enrollment ID: I20161031002525 |
| Provider Name | Lindsay Ann Bouchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417480427 PECOS PAC ID: 4587924766 Enrollment ID: I20180208000481 |
| Provider Name | Virginia Denise Ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194010918 PECOS PAC ID: 4082965488 Enrollment ID: I20180925000843 |
| Provider Name | Mylena Avalos Dominguez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861970337 PECOS PAC ID: 1355695487 Enrollment ID: I20191205001152 |
| Provider Name | Marcela Quintero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952966624 PECOS PAC ID: 1052744877 Enrollment ID: I20191210001195 |
| Provider Name | Courtney Ann Rhoades |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679126262 PECOS PAC ID: 5496180846 Enrollment ID: I20200114000760 |
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