INNOVATIVE HEALTH AND WELLNESS CENTER (NPI# 1265862676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265862676 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE HEALTH AND WELLNESS CENTER |
| Practice Address |
297 Lake Havasu Ave S 200 Lake Havasu City AZ 86403-6526 |
| Practice Telephone | 9288547666 |
| Practice Fax Number | 9288547660 |
| Mailing Telephone | 9288547666 |
| Mailing Fax Number | 9288547660 |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2013-11-21 |
| Authorized Official Name | SUMMER YVONNE TILGNER (OWNER) |
| Authorized Official Telephone | 9288547666 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
13-00030589 | AZ | Nursing Service Providers |
| Street Address |
297 LAKE HAVASU AVE S 200 |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-6526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124011390 | June Franzen | Nurse Practitioner | 297 Lake Havasu Ave S, Suite 200, Lake Havasu City, AZ 86403-6526 | 2005-08-23 |
| 1992136873 | Innovative Womens Health Care of Havasu Pllc | Nurse Practitioner | 297 Lake Havasu Ave S, Suite 106, Lake Havasu City, AZ 86403-6526 | 2013-12-03 |
| 1063849388 | Havasu Neurological Center Pllc | Psychiatry & Neurology | 297 Lake Havasu Ave S, Suite 106, Lake Havasu City, AZ 86403-6526 | 2013-10-01 |
| 1588097349 | Innovative Primary Care Clinic of Havasu Pllc | Nurse Practitioner | 297 Lake Havasu Ave S, Suite 106, Lake Havasu City, AZ 86403-6526 | 2013-08-15 |
| 1154765121 | Panacea Brain and Spine, LLC | Non-Pharmacy Dispensing Site | 297 Lake Havasu Ave S, Suite 204, Lake Havasu City, AZ 86403-6526 | 2013-04-22 |
| 1356695431 | Desert Mountain Orthopaedics & Sports Medicine LLC | Orthopaedic Surgery | 297 Lake Havasu Ave S, Suite 108, Lake Havasu City, AZ 86403-6526 | 2012-10-29 |
| 1962660134 | Maame Ampomah Dankwah-quansah | Psychiatry & Neurology | 297 Lake Havasu Ave S, Suite 106, Lake Havasu City, AZ 86403-6526 | 2008-05-23 |
| 1124202726 | E Franklin Livingstone Md PC | Physical Medicine & Rehabilitation | 297 Lake Havasu Ave S, Ste 106, Lake Havasu City, AZ 86403-6526 | 2007-12-19 |
| 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 | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518579044 | Haoting Pei | Registered Nurse | 3325 Kiowa Blvd S, Lake Havasu City, AZ 86404-5206 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568740 | Julia Levikov | Registered Nurse | 17018 N 57th St, Scottsdale, AZ 85254-6406 | 2020-11-04 |
| 1932709656 | Samantha Ashlee Wirth | Registered Nurse | 16316 N Lasso Dr, Surprise, AZ 85374-5445 | 2020-10-30 |
| 1417554338 | Diana Valencia | Registered Nurse | 11878 W Thomas Arron Dr, Marana, AZ 85653-8033 | 2020-10-04 |
| 1558978098 | Paige Cisar | Registered Nurse | 14418 W Meeker Blvd Ste B-210, Sun City West, AZ 85375-5283 | 2020-09-29 |
| 1861004731 | Amy Ellen Watson | Registered Nurse | 3944 W Pine Creek Way, Tucson, AZ 85745-7114 | 2020-08-20 |
| 1841817343 | Lynley Rachel Thowson | Registered Nurse | 17725 S Placita Junio, Green Valley, AZ 85614-4436 | 2020-06-30 |
| 1861028581 | Jessica H Rose | Registered Nurse | 584 E Blue Rock Way, Vail, AZ 85641-2270 | 2020-03-13 |
| 1508416488 | Melissa Diane Brown | Registered Nurse | 3250 E Hermosa Vista Dr, Mesa, AZ 85213-1702 | 2019-09-12 |
| 1477019628 | Aurea Plotado | Registered Nurse | 4219 W Villa Maria Dr, Glendale, AZ 85308-1716 | 2019-02-13 |
| 1114416989 | Nichole Brianna Wardle-sanford | Registered Nurse | 5868 E Kathleen Rd, Scottsdale, AZ 85254-1861 | 2018-05-07 |
| 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 AND WELLNESS CENTER.
| 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.