Dorthea Jeanette Finicum
Individual provider Active NPI Specialist · Paulden, AZ
NPI 1063572154 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063572154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 2150 Monte Vista
Paulden, AZ 96334 - Phone
- (928) 636-0505
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
2150 Monte Vista
Paulden, AZ 96334
Mailing address
PO Box 98
Paulden, AZ 86334-0098
Phone (928) 636-0505
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8A4763 | Other | AZ | AHCCCS |
Other providers in Paulden, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.