Violet Tsosie
Individual provider Active NPI Contractor · Ganado, AZ
NPI 1821343013 · NPPES record last updated Jul 13, 2012
Key facts
- NPI
- 1821343013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 650556 (AZ)
- Practice address
- HC 58 Box 70
Ganado, AZ 86505-9708 - Phone
- (928) 890-9474
- NPI assigned
- Jul 13, 2012
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 650556 | AZ | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 650556 | AZ | Yes |
Addresses
Primary practice location
HC 58 Box 70
Ganado, AZ 86505-9708
Mailing address
HC58 Box 70 Unit 178
Ganado, AZ 86505
Phone (928) 890-9474
Other providers in Ganado, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2012. 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.