Organization
COPPER BASIN FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA MICHELLE HOOSE RN MSN FNP-C (PRESIDENT)
(480) 888-2010
Entity
Organization
Contact information
Practice address
20185 E OCOTILLO RD, SUITE 104, QUEEN CREEK, AZ 85242-7663
(480) 888-2010
(480) 888-2074
Mailing address
20185 E OCOTILLO RD, SUITE 104, QUEEN CREEK, AZ 85242-7663
(480) 888-2010
(480) 888-2074
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP2470
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237244
—
AZ
Enumeration date
09/06/2007
Last updated
05/08/2008
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