Individual
MARK REID MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 779-7880
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
6743505-4405
UT
363LA2100X
Acute Care Nurse Practitioner
Primary
AP7279
AZ
Other
Enumeration date
08/21/2013
Last updated
09/24/2020
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