Provider Demographics
NPI:1609289438
Name:DESERT CARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:DESERT CARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WYER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:928-259-7565
Mailing Address - Street 1:2140 W 24TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8877
Mailing Address - Country:US
Mailing Address - Phone:928-259-7565
Mailing Address - Fax:
Practice Address - Street 1:2140 W 24TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8877
Practice Address - Country:US
Practice Address - Phone:928-259-7565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESERT CARE ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-10
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3257363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty