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Organization

US PUBLIC HEALTH COMMISSION CORPS

Active
Other names
Indian Health Services
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY MARIE FATH FNP-BC (NURSE PRACTITIONER)
(724) 747-5221
Entity
Organization

Contact information

Practice address
7900 S J STOCK RD, INDIAN HEALTH SERVICE, SAN XAVIER HEALTH CLINIC, TUCSON, AZ 85746-7012
(520) 295-2481
Mailing address
180 FERNCLIFF RD, PO BOX 274, RICES LANDING, PA 15357-1167
(724) 747-5221

Taxonomy

Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
SP012937
PA
261QU0200X
Urgent Care Clinic/Center
SP012937
PA

Other

Enumeration date
09/19/2016
Last updated
09/19/2016
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