Marilyn Masayesva, RN

Individual provider Active NPI Medical-Surgical Registered Nurse · Polacca, AZ

NPI 1881736072 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1881736072
Entity type
Individual (NPI type 1)
Primary specialty
Medical-Surgical Registered Nurse 163WM0705X
License
RN041425 (AZ)
Practice address
Hwy 264, MP 388
Polacca, AZ 86042
Phone
(928) 737-6000
Fax
(928) 737-6369
NPI assigned
Feb 13, 2007
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN041425AZMDMedical-Surgical Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN041425 AZ Yes

Addresses

Primary practice location

Hwy 264, MP 388
Polacca, AZ 86042

Mailing address

PO Box 4000
Polacca, AZ 86042-4000
Phone (928) 737-6000

Other providers in Polacca, AZ

All providers in Polacca, AZ · Medical-Surgical Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.