Healthcare Provider Details

I. General information

NPI: 1134371917
Provider Name (Legal Business Name): ALBERTA DIANE ESPINOZA-LYONS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2008
Last Update Date: 05/28/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US 191 & AZ 264
GANADO AZ
86505
US

IV. Provider business mailing address

4141 TOWNSHIP ROAD 223 SE
NEW LEXINGTON OH
43764
US

V. Phone/Fax

Practice location:
  • Phone: 928-755-4632
  • Fax: 928-755-4831
Mailing address:
  • Phone: 740-342-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN260365
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number10303 NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number320378
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: