Provider Demographics
NPI:1669708301
Name:NECHIPORENKO, CLAIRE FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:FRANCES
Last Name:NECHIPORENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLAIRE
Other - Middle Name:FRANCES
Other - Last Name:LONGHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4212 N 16TH ST
Mailing Address - Street 2:PHOENIX INDIAN MEDICAL CENTER
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5319
Mailing Address - Country:US
Mailing Address - Phone:602-263-1200
Mailing Address - Fax:
Practice Address - Street 1:4212 N 16TH ST
Practice Address - Street 2:PHOENIX INDIAN MEDICAL CENTER
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5319
Practice Address - Country:US
Practice Address - Phone:602-263-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR70955208000000X
AZ44504208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ622535Medicaid