Provider Demographics
NPI:1144644287
Name:MASSIEU, MARY ELIZABETH (DNP, FNP -C)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:MASSIEU
Suffix:
Gender:F
Credentials:DNP, FNP -C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:WELSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14600 S. WATERBURY STREET
Mailing Address - Street 2:SUITE A & B
Mailing Address - City:MAYER
Mailing Address - State:AZ
Mailing Address - Zip Code:86333
Mailing Address - Country:US
Mailing Address - Phone:928-271-5490
Mailing Address - Fax:866-205-4076
Practice Address - Street 1:12075 E STATE ROUTE 69
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-4517
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:602-218-4443
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2936392363LF0000X
AZ226377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily