Healthcare Provider Details

I. General information

NPI: 1215605035
Provider Name (Legal Business Name): ANNA MIN ESQUIBEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 09/06/2021
Certification Date: 09/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 N BURK ST
GILBERT AZ
85234-3476
US

IV. Provider business mailing address

7138 E OLLA AVE
MESA AZ
85212-9802
US

V. Phone/Fax

Practice location:
  • Phone: 480-926-3816
  • Fax: 480-813-8789
Mailing address:
  • Phone: 806-418-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number252740
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: