Delores Poe-Ami

Individual provider Active NPI Registered Nurse · Polacca, AZ

NPI 1285036376 · NPPES record last updated Sep 19, 2014

Key facts

NPI
1285036376
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN088587 (AZ)
Practice address
Highway 264 Milepost 388
Polacca, AZ 86042-4000
Phone
(928) 737-6000
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN088587AZMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN088587 AZ Yes

Addresses

Primary practice location

Highway 264 Milepost 388
Polacca, AZ 86042-4000

Mailing address

PO Box 4000
Polacca, AZ 86042-4000

Other identifiers

IdentifierTypeStateIssuer
020529MedicaidAZ

Other providers in Polacca, AZ

All providers in Polacca, AZ · Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.