Healthcare Provider Details

I. General information

NPI: 1184015794
Provider Name (Legal Business Name): ANGELINA ROSA CANJURA F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 W 10TH PL # S100
MESA AZ
85201-3497
US

IV. Provider business mailing address

3877 N 7TH ST STE 400
PHOENIX AZ
85014-5061
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-6797
  • Fax: 602-248-8119
Mailing address:
  • Phone: 602-258-6797
  • Fax: 602-248-8119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP7534
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: