Healthcare Provider Details

I. General information

NPI: 1902135858
Provider Name (Legal Business Name): LUCIA MONICA ESPARZA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 E TANGERINE RD SUITE # 311
ORO VALLEY AZ
85755-6225
US

IV. Provider business mailing address

PO BOX 2425
SKYLAND NC
28776-2425
US

V. Phone/Fax

Practice location:
  • Phone: 520-326-1266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP3523
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: