Zona Black Calf
Individual provider Active NPI Registered Nurse · Kayenta, AZ
NPI 1588086367 · NPPES record last updated Jan 13, 2014
Key facts
- NPI
- 1588086367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN073269 (AZ)
- Practice address
- Hwy 163
BLDG Ka-2010
Kayenta, AZ 86033 - Phone
- (928) 679-4100
- Fax
- (928) 679-4029
- NPI assigned
- Jan 13, 2014
- 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 |
|---|---|---|---|
| RN073269 | AZ | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN073269 | AZ | Yes |
Addresses
Primary practice location
Hwy 163
BLDG Ka-2010
Kayenta, AZ 86033
Mailing address
PO Box 632
Tonalea, AZ 86044
Phone (928) 679-4100
Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2014. 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.