Organization
NORTHERN ARIZONA FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNIE DIANE EVANS DO (CEO)
(928) 243-6881
Entity
Organization
Contact information
Practice address
14 E TUMBLEWEED LANE, TAYLOR, AZ 85939-8593
(928) 243-6881
Mailing address
PO BOX 339, TAYLOR, AZ 85939-0339
(928) 243-6881
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
TAXONOMY CODE
AZ
05
—
579169
—
AZ
Enumeration date
10/31/2019
Last updated
10/31/2019
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