Big Park Family Practice PC

Organization Active NPI Family Nurse Practitioner · Sedona, AZ

NPI 1902000763 · NPPES record last updated Nov 7, 2007

Key facts

NPI
1902000763
Entity type
Organization (NPI type 2)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
AP2648 (AZ)
Legal business name
BIG PARK FAMILY PRACTICE PC
Practice address
61 Bell Rock PLZ
Sedona, AZ 86351-8810
Phone
(928) 300-4783
Fax
(928) 634-0337
NPI assigned
Jun 13, 2007
Organization subpart
No

Authorized official

Name
Ty Montgomery, NP
Title
Owner
Phone
(928) 300-4783

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LF0000X AP2648 AZ Yes

Addresses

Primary practice location

61 Bell Rock PLZ
Sedona, AZ 86351-8810

Mailing address

PO Box 21540
Sedona, AZ 86341-1540
Phone (928) 300-4783

Other providers in Sedona, AZ

All providers in Sedona, AZ · Family Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.