ELFRIEDE E VERNON (NPI# 1205003324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205003324 |
| Entity Type | Individual |
| Full Name | ELFRIEDE E VERNON |
| Credential | PA |
| Practice Address |
7219 N Litchfield Rd Luke Afb AZ 85309-1529 |
| Practice Telephone | 6238562273 |
| Practice Fax Number | 6238564157 |
| Mailing Telephone | 6238562273 |
| Mailing Fax Number | 6238564157 |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2018-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA13986 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LICENSE | PA13986 | 01 |
| Street Address |
7219 N LITCHFIELD RD |
| City | LUKE AFB |
| State | AZ |
| Zip Code | 85309-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740281203 | Scott Joseph Lafont | Dentist | 7219 N Litchfield Rd, Dental Clinic, Luke Afb, AZ 85309-1529 | 2005-08-09 |
| 1184262347 | Denise Renee Covert | Nurse Practitioner | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2019-12-18 |
| 1790279685 | Tyler John Gale | Nurse Practitioner | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2018-06-14 |
| 1679091706 | Patrick Andrew Stockton | Nurse Practitioner | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2017-09-09 |
| 1417483074 | Matthew Collins | Military Health Care Provider | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2017-05-02 |
| 1235672114 | Noah Russell | Physician Assistant | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2016-11-28 |
| 1811340565 | Collin Urbanowicz | Physician Assistant | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2016-07-18 |
| 1972986909 | Kristin Haskell | Advanced Practice Midwife | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2015-07-08 |
| 1720402993 | Samuel Beck | Pediatrics | 7219 N Litchfield Rd, Luke Afb, AZ 85309 | 2014-02-09 |
| 1760820989 | Bryan Geoffrey Anderson | General Practice | 7219 N Litchfield Rd, 56 Amds (bldg 810), Luke Afb, AZ 85309-1529 | 2013-06-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912466111 | Natalie Ann Korona | Nurse Practitioner | 56 Mdg/mdos/sgof, 7219 N. Litchfield Rd, Luke Afb, AZ 85309 | 2019-03-18 |
| 1558647024 | Cheng Chung Tsai | Pharmacist | 72 19 N Litchfield Road, 56 Medical Group, Luke Afb, AZ 85309 | 2011-10-28 |
| 1053617464 | Bradley William Snyder | Military Health Care Provider | 7224 North 139th Avenue, Glendale, AZ 85309 | 2011-02-02 |
| 1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
| 1104980663 | Maurice Edgar Young | Obstetrics & Gynecology | 56th Aerospace Medicine Squadron, Luke Afb, AZ 85309 | 2006-12-20 |
| 1679658538 | Wayne Allen Beaver | Psychologist | Luke Air Force Base, Bldg 317, Glendale, AZ 85309 | 2006-10-26 |
| 1306945472 | 56th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Bldg 810, Luke Afb, AZ 85309 | 2006-09-22 |
| 1679676571 | Anita Glenn-reller | Counselor | 317 Lightning Ave, Luke Afb, AZ 85309 | 2006-09-06 |
| 1346784881 | Kaleigh Moses | Registered Nurse | 13960 W Eagle St, Luke Air Force Base, AZ 85309-1426 | 2016-12-16 |
| 1376893511 | Melissa Ann Parra | Dentist | 7219 N Litchfield Rd., 56th Medical Group, Luke Afb, AZ 85309-1525 | 2012-09-14 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811340565 | Collin Urbanowicz | Physician Assistant | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2016-07-18 |
| 1023331030 | Jessica Harris Rackley | Physician Assistant | 7219 N Litchfield Rd, Luke Afb, AZ 85309-1529 | 2010-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
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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.