Provider Demographics
NPI:1114383924
Name:DESERT SKY WOMENS HEALTHCARE INC
Entity Type:Organization
Organization Name:DESERT SKY WOMENS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC
Authorized Official - Phone:509-491-3889
Mailing Address - Street 1:PO BOX 6918
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0602
Mailing Address - Country:US
Mailing Address - Phone:509-491-3889
Mailing Address - Fax:509-491-3649
Practice Address - Street 1:919 S AUBURN ST
Practice Address - Street 2:SUITE A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5662
Practice Address - Country:US
Practice Address - Phone:509-491-3889
Practice Address - Fax:509-491-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty