ELIZABETH KAY SUPRAK (NPI# 1710496146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710496146 |
| Entity Type | Individual |
| Full Name | ELIZABETH KAY SUPRAK |
| Credential | PA-C |
| Practice Address |
1030 E Guadalupe Rd Tempe AZ 85283 |
| Mailing Address |
1030 E Guadalupe Rd Tempe AZ 85283-3044 |
| Practice Telephone | 4804911898 |
| Practice Fax Number | 4804915108 |
| Mailing Telephone | 4804911898 |
| Mailing Fax Number | 4804915108 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2019-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
6825 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7233 E Baseline Rd Ste 126, Mesa, AZ 85209 | 4806992222 |
| Street Address |
1030 E GUADALUPE RD |
| City | TEMPE |
| State | AZ |
| Zip Code | 85283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326184292 | Pervaiz Akhter | Psychiatry & Neurology | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2007-01-29 |
| 1629545579 | Tanner Cook | Physician Assistant | 1030 E Guadalupe Rd, Tempe, AZ 85283 | 2018-10-30 |
| 1346775459 | Raman K. Saini | Psychologist | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2017-04-26 |
| 1730614256 | Amber Ellington | Nutritionist | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2017-04-21 |
| 1487187282 | Channing Cabanillas | Physician Assistant | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2017-04-07 |
| 1457890451 | Heather Montierth | Counselor | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2017-02-23 |
| 1821485954 | Transitions Center Pllc | Psychiatry & Neurology | 1030 E Guadalupe Rd, Tempe, AZ 85283-3044 | 2015-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093373284 | Odilette Trevizo | Registered Nurse | Beautiful You Med Spa, 123 E Baseline Rd Ste D208, Tempe, AZ 85283 | 2019-06-03 |
| 1538631981 | Baseline Dental Care Pllc | Dentist | 1980 E Baseline Road Suite 101, Tempe, AZ 85283 | 2018-12-26 |
| 1912409228 | Laura Lee Jones | Social Worker | 438 W. Seed Farm Road, Sacaton, AZ 85283 | 2018-03-02 |
| 1609226364 | Clean Colonic LLC | Public Health or Welfare | 7560 S. Willow Dr, Tempe, AZ 85283 | 2016-06-14 |
| 1235583212 | Seema Bacon | Counselor | 2111 E Baseline Rd Ste D2, Tempe, AZ 85283 | 2016-04-15 |
| 1326436908 | Dale E King | Social Worker | 1405 E. Guadalupe Road, Tempe, AZ 85283 | 2015-01-05 |
| 1194135871 | Greater Phoenix Psychiatric Associate Pllc | Psychiatry & Neurology | 6530 S Maple Ave, Tempe, AZ 85283 | 2014-05-02 |
| 1639468077 | Muna A Jama | Pharmacist | 6404 S Mcclintock Dr., Tempe, AZ 85283 | 2011-04-06 |
| 1649580945 | Nancy A Syms | Psychologist | 6350 South Maple Avenue, Tempe, AZ 85283 | 2010-10-20 |
| 1629208400 | Bonnie J Rouzaud | Nurse Practitioner | 1920 E Baseline Road, Tempe, AZ 85283 | 2009-07-15 |
| Find all providers in zip 85283 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194246223 | Jamie Ostdiek | Physician Assistant | 7505 S Mcclintock Dr Ste 103, Tempe, AZ 85283-5042 | 2017-06-28 |
| 1356731624 | Suzanne Strickland | Physician Assistant | 3141 S Mcclintock Dr Ste 1, Tempe, AZ 85282-5682 | 2015-01-26 |
| 1053695437 | Dana Roberts Cohen | Physician Assistant | 1315 W. Southern Ave, Tempe, AZ 85282 | 2011-10-04 |
| 1548410368 | Nicole Marie Lupica | Physician Assistant | 2402 E 5th St, 1485, Tempe, AZ 85281-3390 | 2008-09-29 |
| 1730207184 | Celia R Alvarez-reeder | Physician Assistant | 2033 E Warner Rd, Suite 109, Tempe, AZ 85284-3417 | 2007-03-26 |
| 1376635581 | Carissa Dawn Colgrove | Physician Assistant | 2720 W Baseline Rd # 140, Tempe, AZ 85283 | 2006-09-28 |
| 1689666844 | Shannon E Lunders | Physician Assistant | 433 W. Broadway Road, Tempe, AZ 85281 | 2005-08-15 |
| 1992312474 | Jamie Romero | Physician Assistant | 2033 E Warner Rd Ste 109, Tempe, AZ 85284-3417 | 2020-09-28 |
| 1598238651 | Mcclintock Medical Group, LLC | Physician Assistant | 1855 E Guadalupe Rd Ste 112, Tempe, AZ 85283-3269 | 2019-01-10 |
| 1801374913 | Emma Reeve | Physician Assistant | 2127 E Baseline Rd Ste 104, Tempe, AZ 85283-1537 | 2018-07-31 |
| Find all providers in TEMPE | ||||
Please comment or provide details below to improve the information on ELIZABETH KAY SUPRAK.
| 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.