Provider Demographics
NPI:1033738463
Name:NH LAMBERT PA-C LLC
Entity Type:Organization
Organization Name:NH LAMBERT PA-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:480-201-2564
Mailing Address - Street 1:1776 N SCOTTDALE RD #368
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252
Mailing Address - Country:US
Mailing Address - Phone:480-201-5264
Mailing Address - Fax:480-393-1970
Practice Address - Street 1:1776 N SCOTTDALE RD #368
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:AZ
Practice Address - Zip Code:85252
Practice Address - Country:US
Practice Address - Phone:480-201-5264
Practice Address - Fax:480-393-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ570631Medicaid