Healthcare Provider Details

I. General information

NPI: 1609698596
Provider Name (Legal Business Name): CYNTHIA DANIELLE ESCARCEGA LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35959 N 7TH AVE
DESERT HILLS AZ
85086-6306
US

IV. Provider business mailing address

4331 W MORROW DR
GLENDALE AZ
85308-4414
US

V. Phone/Fax

Practice location:
  • Phone: 623-445-5000
  • Fax:
Mailing address:
  • Phone: 602-717-8460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLP0044874
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: