Healthcare Provider Details
I. General information
NPI: 1407669658
Provider Name (Legal Business Name): VALERIA NORZAGARAY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/30/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2530 E SOUTHERN AVE
MESA AZ
85204-5411
US
IV. Provider business mailing address
10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US
V. Phone/Fax
- Phone: 480-834-4188
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 318825 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: