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BERNADYNE AGAN FNP-BC
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1477104842
Individual Registrant: BERNADYNE AGAN FNP-BC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
200 W HOSPITAL DRIVE WHITERIVER, AZ 85941 US
Tel: 928-338-4911 Fax: --
Tel: 928-338-4911 Fax: --
Contact information for business:
5061 S CUB LAKE RD SHOW LOW, AZ 85901-7825 US
Tel: 928-228-3861 Fax: --
Tel: 928-228-3861 Fax: --
Registration Information:
NPI: 1477104842
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | AZ | 232206 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
