Organization
DESERT FAMILY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA D HANSON M.S. F.N.P. (MANAGING MEMBER)
(928) 451-6559
Entity
Organization
Contact information
Practice address
765 W AZURE DR, CAMP VERDE, AZ 86322-4945
(928) 451-6559
Mailing address
765 W AZURE DR, CAMP VERDE, AZ 86322-4945
(928) 451-6559
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
RN 114868 AP 2200
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP2200
AP LICENSE #
AZ
01
—
F0805137
CERTIFICATION NUMBER AANP
—
01
—
RN 114868
RN LICENSE #
AZ
Enumeration date
01/31/2007
Last updated
03/07/2023
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