COUNTRY CLINIC PC
Nursing at Mandarin Dr, Queen Creek, AZ

License number
Arizona AP2088
Category
Nursing
Type
Family
Owner
Name: KATHERINE C HAKEMAN NP
Title: PRESIDENT
Phone: (480) 369-0582
Address
Address
26416 S Mandarin Dr, Queen Creek, AZ 85142
National Provider ID: 1740561562
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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COUNTRY CLINIC, PC

26416 S Mandarin Dr, Queen Creek, AZ 85142

Industry:
Health and Allied Services, Nec, Nsk, Health/Allied Services
Registration:
Jan 23, 2008
State ID:
-1423778-8
Expiration:
PERPETUAL
President, Nurse Practitioner, Principal:
Katherine Hakeman (President, Nurse Practitioner, Principal), 26416 S Mandarin Dr, Queen Creek, AZ 85142 (Physical)
Agent:
James W Ericksen,1988 E Baseline #103, Tempe, AZ 85283 (Physical)

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