Individual
MARY PAT NESBIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1201 S 7TH AVE, PHOENIX, AZ 85007
(602) 258-5111
Mailing address
14780 W MOUNTAIN VIEW BLVD, STE 110, SURPRISE, AZ 85374-7280
(623) 374-7774
(855) 420-6361
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2601
AZ
363A00000X
Physician Assistant
59918
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GROUP #
—
01
—
453051001
GROUP HEALTH GRP #
—
05
—
693087
—
AZ
01
—
860373636
HUMANA GROUP #
AZ
01
—
A1U1436
HEALTHNET GROUP #
AZ
01
—
CO301824
MEDICARE
AZ
Enumeration date
11/02/2005
Last updated
11/09/2022
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