Healthcare Provider Details

I. General information

NPI: 1225672785
Provider Name (Legal Business Name): ROBERTA LEE ESCALERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBERTA LEE PATRICK (NIXON) FNP-C

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 E BROADWAY RD STE 9
MESA AZ
85208-1156
US

IV. Provider business mailing address

7525 E BROADWAY RD STE 9
MESA AZ
85208-1156
US

V. Phone/Fax

Practice location:
  • Phone: 480-981-2700
  • Fax:
Mailing address:
  • Phone: 480-981-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number233666
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number233666
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: