Provider Demographics
NPI:1437112240
Name:QUADE, CARA LEE (PMHNP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LEE
Last Name:QUADE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:LEE
Other - Last Name:QUADE-FRIEBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2500 SHOW LOW LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-7929
Mailing Address - Country:US
Mailing Address - Phone:928-537-2951
Mailing Address - Fax:928-537-8520
Practice Address - Street 1:2500 SHOW LOW LAKE RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7929
Practice Address - Country:US
Practice Address - Phone:928-537-2951
Practice Address - Fax:928-537-8520
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1615363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ751398OtherAHCCCS