INNOVATIVE HEALTH CARE OF HAVASU LLC (NPI# 1114230893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114230893 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE HEALTH CARE OF HAVASU LLC |
| Practice Address |
297 Lake Havasu Ave South Suite 200 Lake Havasu City AZ 86403 |
| Practice Telephone | 9288547666 |
| Practice Fax Number | 9288547660 |
| Mailing Telephone | 9288547666 |
| Mailing Fax Number | 9288547660 |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | MRS. SUMMER YVONNE TILGNER (OWNER) |
| Authorized Official Telephone | 9288547666 |
| Authorized Official Credential | DNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
AP3726 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
297 LAKE HAVASU AVE SOUTH SUITE 200 |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184190688 | Amy Marie Burke | Clinical Nurse Specialist | 9201 E. Moutain View Rd #220, Scottsdale, AZ 85258 | 2018-10-23 |
| 1235581794 | Dr Judith Ochieng Fnp-bc LLC | Clinical Nurse Specialist | 1925 W Orange Grove Rd Ste 103, Tucson, AZ 85704-1150 | 2016-07-08 |
| 1598115388 | Jeff John Waknitz | Clinical Nurse Specialist | 14820 W Wethersfield Rd, Surprise, AZ 85379-5968 | 2016-06-13 |
| 1477998508 | Cheryl Ann Parker | Clinical Nurse Specialist | 2121 N Tanque Verde Loop Rd, Tucson, AZ 85749-8532 | 2013-05-02 |
| 1780945469 | Margot Veronica Wilson | Clinical Nurse Specialist | 1625 W Ina Rd Ste 123, Tucson, AZ 85704-1975 | 2012-05-30 |
| 1568746683 | Maura Lee Schoenle | Clinical Nurse Specialist | 10070 S Nogales Hwy, Tucson, AZ 85756-9209 | 2011-10-07 |
| 1174719397 | Patricia Kate Paradis | Clinical Nurse Specialist | 10046 N Metro Pkwy W, Suite 115, Phoenix, AZ 85051-1437 | 2007-09-20 |
| 1053844811 | Larissa Flores | Clinical Nurse Specialist | 10815 W Mcdowell Rd Ste 305, Avondale, AZ 85392-5016 | 2017-04-09 |
| 1578096798 | Advanced Clinical Practitioners, LLC | Clinical Nurse Specialist | 20823 N Cave Creek Rd, Suite 103, Phoenix, AZ 85024-4468 | 2017-04-05 |
| 1093257172 | Stewart Lewis | Clinical Nurse Specialist | 9302 E 22nd St, Tucson, AZ 85710 | 2016-11-07 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on INNOVATIVE HEALTH CARE OF HAVASU LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.