MR. RENE VENZON TICSAY (NPI# 1184175432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184175432 |
Entity Type | Individual |
Full Name | MR. RENE VENZON TICSAY |
Credential | RT |
Practice Address |
Kayenta Health Center Highway 160 Kayenta AZ 86033 |
Mailing Address |
15951 W Cocopah St Goodyear AZ 85338-7930 |
Practice Telephone | 9286974306 |
Practice Fax Number | 9286974107 |
Mailing Telephone | 9286974306 |
Mailing Fax Number | 9286974107 |
Enumeration Date | 2016-10-21 |
Last Update Date | 2016-10-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
271815 | MN | Technologists, Technicians & Other Technical Service Providers |
N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
14256 | AZ | Technologists, Technicians & Other Technical Service Providers |
Street Address |
KAYENTA HEALTH CENTER HIGHWAY 160 |
City | KAYENTA |
State | AZ |
Zip Code | 86033 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962048306 | Pauletta A Butterfly | Social Worker | Hwy. 160 Mp 394.3, Kayenta, AZ 86033 | 2019-11-20 |
1871143255 | Andrea Dawn Begay | Nurse's Aide | Us Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-09-17 |
1083264451 | Mavis Ann Bahe | Nurse's Aide | Kayenta Health Center, Us Hwy 160, Mp 394.3, Kayenta, AZ 86033 | 2019-09-17 |
1609420165 | Emily Ingram Nimon | Registered Nurse | Kayenta Health Center Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-08-01 |
1700439577 | Sherri A Verdon | Registered Nurse | Hwy 160 M.p 394.3, Kayenta, AZ 86033 | 2019-07-22 |
1447712104 | Cynthia Kaye Robbins | Registered Nurse | Us Highway 160 Mile Post 394.3, Kayenta, AZ 86033 | 2019-04-02 |
1871051052 | Brian Jason Miller | Registered Nurse | Hwy 160, Mile Post 394.3, Kayenta, AZ 86033 | 2019-03-07 |
1265915615 | Marissa Brooke Wall | Optometrist | 394.3 Us-160, Kayenta, AZ 86033 | 2018-09-12 |
1467952762 | Michael Ruddy | Pharmacist | Hwy 160 1/2 Mile South of Mile Post 394.3, Kayenta, AZ 86033 | 2018-02-14 |
1922516319 | Xavier Kelton Nelson | Spec/Tech, Pathology | Highway 160 Mp 394.3, Kayenta Health Center, Kayenta, AZ 86033 | 2018-01-19 |
Find all providers in zip 86033 |
Taxonomy Code | 2471C3402X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Radiologic Technologist |
Specialization | Radiography |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497205710 | Kayenta Health Center, Radiology Dept | Radiologic Technologist | Highway 160, Kayenta Health Center, Kayenta, AZ 86033 | 2016-10-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184247173 | Anthony Jacob Hannon | Radiologic Technologist | 8537 W Windrose Dr, Peoria, AZ 85381-8158 | 2020-05-25 |
1912382573 | Amber Diego | Radiologic Technologist | 1417 N Santa Anna Ct, Chandler, AZ 85224-8327 | 2015-07-24 |
1184962276 | William David Reid | Radiologic Technologist | 5535 E Button Ln, Flagstaff, AZ 86001-9705 | 2013-01-23 |
1447286737 | Transray of Arizona, P.C. | Radiologic Technologist | 930 N Mesa Dr, #1056, Mesa, AZ 85201-4321 | 2006-06-25 |
1891792552 | Robert Brian Jackson | Radiologic Technologist | 2011 W Mulberry Dr, Phoenix, AZ 85015-5720 | 2005-07-07 |
1922656453 | Erick Giovanni Nova Sr. | Radiologic Technologist | 3300 W Camelback Rd, Phoenix, AZ 85017-3030 | 2019-08-28 |
1245727734 | Lynelle Zahne | Radiologic Technologist | 167 N Main Street, Tuba City, AZ 86045-0600 | 2018-04-19 |
1528498037 | Frank Mamola | Radiologic Technologist | 209 E Rose Ln, Phoenix, AZ 85012-1242 | 2013-11-19 |
1023365665 | Bart Trujillo | Radiologic Technologist | 12033 Agency Rd, Parker, AZ 85344-7718 | 2012-08-14 |
1295094183 | Karalyn Begay | Radiologic Technologist | 167 North Main Street, Tuba City, AZ 86045-0600 | 2012-05-11 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.