Individual
MRS. LEA E WAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.F.N.P.
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
207Q00000X
Family Medicine Physician
Primary
154
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141317001
MERCYCALL
AZ
01
—
860815386001
TRICARE
AZ
Enumeration date
07/13/2005
Last updated
10/25/2012
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