Provider Demographics
NPI:1063651420
Name:MOBILE HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MOBILE HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:928-772-1673
Mailing Address - Street 1:12262 E BRADSHAW MOUNTAIN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DEWEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86327-6032
Mailing Address - Country:US
Mailing Address - Phone:928-772-1673
Mailing Address - Fax:928-772-1674
Practice Address - Street 1:12262 E BRADSHAW MOUNTAIN RD
Practice Address - Street 2:SUTIE #2
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-6032
Practice Address - Country:US
Practice Address - Phone:928-772-1673
Practice Address - Fax:928-772-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2013-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ128380OtherMEDICARE PTAN