Basic Information
| Provider Information | |||||||||
| NPI: | 1942729363 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAULEY | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6422 E SPEEDWAY BLVD | ||||||||
| Address2: | STE 150 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857101149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203183004 | ||||||||
| FaxNumber: | 5203183061 | ||||||||
| Practice Location | |||||||||
| Address1: | 6422 E SPEEDWAY BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857101149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203183004 | ||||||||
| FaxNumber: | 5203183061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2017 | ||||||||
| LastUpdateDate: | 08/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 5601010889 | MI | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 027862 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 54863 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 7059 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA9115386 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | PA9115386 | 01 | FL | MEDICAL LICENSE | OTHER | 027862 | 01 | NY | MEDICAL LICENSE | OTHER | 54863 | 01 | CA | MEDICAL LICENSE | OTHER | 5601010889 | 01 | MI | MEDICAL LICENSE | OTHER | 7059 | 01 | AZ | MEDICAL LICENSE | OTHER |