Organization
TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS ANN DIPAOLA FNP (FAMILY NURSE PRACTITIONER)
(603) 731-5907
Entity
Organization
Contact information
Practice address
45 CAPRI BLVD STE F, LAKE HAVASU CITY, AZ 86403-5657
(928) 234-1177
(928) 733-6259
Mailing address
3869 CHESAPEAKE PL, LAKE HAVASU CITY, AZ 86406-4343
(603) 731-5907
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
AP9834
AZ
261QP2300X
Primary Care Clinic/Center
AP9834
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669836748
—
CA
Enumeration date
10/21/2017
Last updated
06/16/2018
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