Organization
LEA A WAY
Active
Other names
Yarnell Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEA E WAY C F N P (OWNER)
(928) 427-3411
Entity
Organization
Contact information
Practice address
22869 US HWY 89, YARNELL, AZ 85362
(928) 427-3411
(928) 427-6541
Mailing address
PO BOX 728, YARNELL, AZ 85362-0728
(928) 427-3411
(928) 427-6541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
154
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141317
—
AZ
Enumeration date
06/01/2007
Last updated
08/22/2020
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