Organization
INNOVATIVE HEALTH CARE OF HAVASU LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUMMER YVONNE TILGNER DNP (OWNER)
(928) 854-7666
Entity
Organization
Contact information
Practice address
297 LAKE HAVASU AVE SOUTH, SUITE 200, LAKE HAVASU CITY, AZ 86403
(928) 854-7666
(928) 854-7660
Mailing address
297 LAKE HAVASU AVE SOUTH, SUITE 200, LAKE HAVASU CITY, AZ 86403
(928) 854-7666
(928) 854-7660
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
AP3726
AZ
Other
Enumeration date
07/22/2010
Last updated
05/23/2018
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