COPPER BASIN FAMILY MEDICINE PLLC (NPI# 1538354188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538354188 |
| Entity Type | Organization |
| Organization Name | COPPER BASIN FAMILY MEDICINE PLLC |
| Practice Address |
20185 E Ocotillo Rd Suite 104 Queen Creek AZ 85242-7663 |
| Practice Telephone | 4808882010 |
| Practice Fax Number | 4808882074 |
| Mailing Telephone | 4808882010 |
| Mailing Fax Number | 4808882074 |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2008-05-08 |
| Authorized Official Name | MS. BARBARA MICHELLE HOOSE (PRESIDENT) |
| Authorized Official Telephone | 4808882010 |
| Authorized Official Credential | RN MSN FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP2470 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 237244 | 05 |
| Street Address |
20185 E OCOTILLO RD SUITE 104 |
| City | QUEEN CREEK |
| State | AZ |
| Zip Code | 85242-7663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467438929 | Merrill R. Heslop | Social Worker | 20185 E Ocotillo Rd, #105, Queen Creek, AZ 85242-8799 | 2005-12-16 |
| 1285730085 | Barbara M Hoose | Nurse Practitioner | 20185 E Ocotillo Rd, Suite 104, Queen Creek, AZ 85242-7663 | 2006-09-16 |
| 1689691529 | Diane Maree Whisler | Counselor | 20185 E Ocotillo Rd, Queen Creek, AZ 85242-8799 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932430618 | Di Nguyen | Pharmacist | 3111 West Hunt Highway, Queen Creek, AZ 85242 | 2010-01-20 |
| 1174857056 | Jessica Lynn Donnelly | Behavioral Analyst | 21007 E. Avendia Del Valle, Queen Creek, AZ 85242 | 2009-09-25 |
| 1306093984 | Charles Mckenzie | Dentist | 40815 N Ironwood Drive, Ste A102, Queen Creek, AZ 85242 | 2008-08-26 |
| 1104014943 | Queen Creek Smiles, LLP | Dentist | 18550 East Rittenhouse Road, Suite 103, Queen Creek, AZ 85242 | 2007-10-05 |
| 1972700359 | Sunrise Internal Medicine PC | Internal Medicine | 22707 S. Ellsworth Rd., Suite #h105, Queen Creek, AZ 85242 | 2007-06-29 |
| 1083811277 | Brian Joseph Goodman | Dentist | 18610 E. Rittenhouse Rd., Queen Creek, AZ 85242 | 2007-06-29 |
| 1972704757 | San Tan Urgent Care Health Center | Clinic/Center | 21321 E Ocotillo Road, Suite 118, Queen Creek, AZ 85242 | 2007-05-30 |
| 1538375647 | Jennifer Jean Job | Occupational Therapy Assistant | 3575 E Lawndale Place, Queen Creek, AZ 85242 | 2007-05-15 |
| 1972718823 | Eric Joseph Harris | Dentist | 20261 E. Ocotillo Road, Suite 120, Queen Creek, AZ 85242 | 2007-05-14 |
| 1477767010 | San Tam Dental Care & Mobile Clinic PC | Dentist | 22240 S Ellsworth Rd, Suite 102, Queen Creek, AZ 85242 | 2007-05-10 |
| Find all providers in zip 85242 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845692 | Ramon Nava Jr. | Nurse Practitioner | 162 W Evergreen Pear Ave, Queen Creek, AZ 85140-7911 | 2020-09-12 |
| 1083265516 | Yva Jean-marc | Nurse Practitioner | 22707 S Ellsworth Rd Ste H101, Queen Creek, AZ 85142-7568 | 2019-09-25 |
| 1104472554 | Tracy Holman-speights | Nurse Practitioner | 22652 E Avenida Del Valle, Queen Creek, AZ 85142-9045 | 2019-08-12 |
| 1235691494 | Kimball Jones Carpenter | Nurse Practitioner | 19002 E Kingbird Dr, Queen Creek, AZ 85142-6865 | 2019-04-04 |
| 1487166484 | Marianne Powell | Nurse Practitioner | 21384 E Mewes Rd, Queen Creek, AZ 85142-7975 | 2017-10-30 |
| 1891233714 | Candee J. Eisenhart | Nurse Practitioner | 21321 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142 | 2017-02-11 |
| 1790231546 | Carrie Church | Nurse Practitioner | 20185 E Ocotillo Rd Ste 104, Queen Creek, AZ 85142 | 2016-08-31 |
| 1215380969 | William Bautista Amistad Jr. | Nurse Practitioner | 19244 E Camacho Rd, Queen Creek, AZ 85142-6077 | 2016-07-18 |
| 1740561562 | Country Clinic PC | Nurse Practitioner | 26416 S Mandarin Dr, Queen Creek, AZ 85142-9411 | 2011-09-07 |
| 1982776563 | Sharon Toth | Nurse Practitioner | 31258 N Trail Dust Dr, Queen Creek, AZ 85143-4139 | 2006-11-15 |
| Find all providers in QUEEN CREEK | ||||
| City | QUEEN CREEK |
| Zip Code | 85242 |
Please comment or provide details below to improve the information on COPPER BASIN FAMILY MEDICINE PLLC.
| 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.