Mavis Ann Bahe – Nurse's Aide in Kayenta, AZ

Key facts

NPI: 1083264451
Entity type: Individual (NPI type 1)
Primary specialty: Nurse's Aide 376K00000X
License: CNA220293 (AZ)
Practice address: Kayenta Health Center, US Hwy 160, MP 394.3
Kayenta, AZ 86033
Phone: (928) 697-5141
NPI assigned: Sep 17, 2019
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

State licenses

License	State	Type	Specialty
CNA220293	AZ	MD	Nurse's Aide

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse's Aide	376K00000X	CNA220293	AZ	Yes

Addresses

Primary practice location

Kayenta Health Center, US Hwy 160, MP 394.3
Kayenta, AZ 86033

Mailing address

PO Box 1536
Kayenta, AZ 86033-1536
Phone (928) 679-5005

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 17, 2019.

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1083264451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1536",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "860331536",
            "telephone_number": "928-679-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAYENTA HEALTH CENTER, US HWY 160, MP 394.3",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHE",
        "first_name": "MAVIS",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": "CNA220293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kayenta, AZ

All providers in Kayenta, AZ · Nurse's Aide in Arizona

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2019. 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.

Verify at the official NPI Registry.