Country Club Medical Weight Loss & Wellness PLLC
NPI 1205616398ActiveOrganization· Nurse Practitioner, Family· Mesa, AZ
Nurse Practitioner, Family in Mesa, Arizona, registered in NPPES in October 2023. The authorized official on file is Flora Issanda Stowater, NP, Owner/Manager.
Overview
| NPI | 1205616398 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 5, 2023 |
| Last updated in NPPES | Oct 5, 2023 |
| Certified by provider | Oct 5, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nurse Practitioner, Family providers in Mesa
- 1154874030
- 1992153696
- 1912187121
- 1447050539
- 1740184605
- 1104738798
- 1154661148
- 1366854721
- 1831462530
- 1285402040
- 1316653579
- 1467173906