Healthcare Provider Details

I. General information

NPI: 1336162866
Provider Name (Legal Business Name): ELIZABETH MARIE TARUFELLI NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH MARIE DUDNEY OR PIOTROWSKI NP-C

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17301 E SPRING VALLEY RD STE F
MAYER AZ
86333-4263
US

IV. Provider business mailing address

17301 E SPRING VALLEY RD STE F
MAYER AZ
86333-4263
US

V. Phone/Fax

Practice location:
  • Phone: 928-632-4909
  • Fax: 928-632-4973
Mailing address:
  • Phone: 928-632-4909
  • Fax: 928-632-4973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2353
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: