Provider Demographics
NPI:1750811816
Name:GARNET PAIN RELIEF SERVICES, LLC
Entity type:Organization
Organization Name:GARNET PAIN RELIEF SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER, CERTIFIED
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:928-358-1221
Mailing Address - Street 1:5658 WHITE MOUNTAIN BLVD STE 21
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85929-5189
Mailing Address - Country:US
Mailing Address - Phone:928-358-1221
Mailing Address - Fax:928-433-6446
Practice Address - Street 1:5658 WHITE MOUNTAIN BLVD STE 21
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:AZ
Practice Address - Zip Code:85929-5189
Practice Address - Country:US
Practice Address - Phone:928-358-1221
Practice Address - Fax:928-433-6446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN138645261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain