Organization
PRIMA MEDICAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE JEAN COLONNA NP (OWNER)
(928) 302-3798
Entity
Organization
Contact information
Practice address
99 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5713
(928) 302-3798
Mailing address
99 RIVIERA DR, LAKE HAVASU CITY, AZ 86403-5713
(928) 302-3798
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/30/2023
Last updated
10/03/2024
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