Advanced Wound Care of Arizona PLLC
NPI 1720839665ActiveOrganization· Nurse Practitioner· Prescott, AZ
Nurse Practitioner in Prescott, Arizona, registered in NPPES in March 2024. The authorized official on file is Ron Olsen, President/Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1720839665 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 28, 2024 |
| Last updated in NPPES | Apr 30, 2026 |
| Certified by provider | Apr 30, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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