Healthcare Provider Details

I. General information

NPI: 1477434801
Provider Name (Legal Business Name): MIREYA LOPEZ FIGUEROA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 N CENTRAL AVE
PHOENIX AZ
85012-1889
US

IV. Provider business mailing address

4525 N CENTRAL AVE
PHOENIX AZ
85012-1889
US

V. Phone/Fax

Practice location:
  • Phone: 602-764-7511
  • Fax:
Mailing address:
  • Phone: 602-764-7511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number319309
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: