Individual provider Active NPI

Marsha A Prince, WHCNP

  • Women's Health Nurse Practitioner
  • Sierra Vista, AZ
National Provider Identifier
1376568899
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN090883 Issued in AZ
Practice address
174 S Coronado Dr
Suite a
Sierra Vista, AZ 85635-6353
Phone
(520) 417-9920
Fax
(520) 417-9919
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN090883 AZ Primary

Addresses

Primary practice location

174 S Coronado Dr
Suite a
Sierra Vista, AZ 85635-6353

Mailing address

174 S Coronado Dr
Suite a
Sierra Vista, AZ 85635-6353
Phone (520) 417-9920

Other identifiers 1

IdentifierTypeStateIssuer
523367MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN090883AZMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Vista Regional Health Center Medical Group LLC CurrentSince Apr 30, 2016 Accepting new patients

Locations

302 El Camino Real
Ste 5
Sierra Vista, AZ 85635
Phone (520) 364-7544

5750 E Highway 90
Ste 200
Sierra Vista, AZ 85635
Phone (520) 263-3500

302 El Camino Real
Ste 10F
Sierra Vista, AZ 85635
Phone (520) 459-3920

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1376568899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 S CORONADO DR",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356353",
            "telephone_number": "520-417-9920",
            "fax_number": "520-417-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 S CORONADO DR",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856356353",
            "telephone_number": "520-417-9920",
            "fax_number": "520-417-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MARSHA",
        "middle_name": "A",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "RN090883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523367",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.