Provider Demographics
NPI:1164498895
Name:MCCARTER-BAYER, ANNIE S (NP)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:S
Last Name:MCCARTER-BAYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:ANN
Other - Last Name:MCCARTER SUMMERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:8861 N DUSKFIRE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-8367
Mailing Address - Country:US
Mailing Address - Phone:520-547-4906
Mailing Address - Fax:
Practice Address - Street 1:2155 W ORANGE GROVE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3118
Practice Address - Country:US
Practice Address - Phone:520-742-0414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN090967163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ619215Medicaid
AZ619215Medicaid
AZP73389Medicare UPIN