Healthcare Provider Details

I. General information

NPI: 1881071793
Provider Name (Legal Business Name): ESTHER R ELLSWORTH BOWERS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ESTHER R ELLSWORTH

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 N 4TH ST
FLAGSTAFF AZ
86004-1816
US

IV. Provider business mailing address

PO BOX 1231
TUCSON AZ
85702-1231
US

V. Phone/Fax

Practice location:
  • Phone: 928-522-9400
  • Fax:
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP7753
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP7753
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: