Organization
IVY HEALTH PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA REYES MENDOZA FNP-C (NURSE PRACTITIONER)
(928) 218-3493
Entity
Organization
Contact information
Practice address
2135 HIGHWAY 95 STE 135, BULLHEAD CITY, AZ 86442-6005
(928) 218-3493
(928) 208-4829
Mailing address
2135 HIGHWAY 95 STE 135, BULLHEAD CITY, AZ 86442-6005
(928) 218-3493
(928) 268-0262
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417306978
NPI
AZ
Enumeration date
04/06/2022
Last updated
10/03/2023
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