Provider Demographics
NPI:1295949626
Name:MCCLESKEY, MARIA A (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:A
Last Name:MCCLESKEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 E CAT BALUE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-6507
Mailing Address - Country:US
Mailing Address - Phone:480-275-4229
Mailing Address - Fax:
Practice Address - Street 1:1437 W AUTO DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1016
Practice Address - Country:US
Practice Address - Phone:602-362-2983
Practice Address - Fax:855-889-8024
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3159363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant