Provider Demographics
NPI:1881143386
Name:HYDER, ARIANNE C (PA-C)
Entity type:Individual
Prefix:
First Name:ARIANNE
Middle Name:C
Last Name:HYDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARIANNE
Other - Middle Name:C
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 31210
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-1210
Mailing Address - Country:US
Mailing Address - Phone:928-773-2222
Mailing Address - Fax:928-773-2599
Practice Address - Street 1:77 W FOREST AVE STE 201
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1483
Practice Address - Country:US
Practice Address - Phone:928-773-2222
Practice Address - Fax:928-773-2599
Is Sole Proprietor?:No
Enumeration Date:2016-09-25
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1881143386OtherUHC
AZ1881143386OtherAZFMC
AZ607904Medicaid
AZZ235849OtherMEDICARE
AZ1881143386OtherAETNA
AZ1881143386OtherCIGNA
AZ1881143386OtherHUMANA
AZ1881143386OtherBCBS