Organization
MOUNTAIN AIR ADULT PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BAILEY-STEPHENS (OWNER)
(602) 301-1557
Entity
Organization
Contact information
Practice address
6026 E TALLY HO DR, CAVE CREEK, AZ 85331-8867
(602) 301-1557
Mailing address
6026 E TALLY HO DR, CAVE CREEK, AZ 85331-8867
(602) 301-1557
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP3245
LICENSE
AZ
Enumeration date
04/06/2021
Last updated
04/06/2021
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