Healthcare Provider Details

I. General information

NPI: 1902733900
Provider Name (Legal Business Name): LITZY KARINA BAUTISTA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LITZY KARINA AGUILERA

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W BEAUTIFUL LN
PHOENIX AZ
85041-8011
US

IV. Provider business mailing address

208 W BEAUTIFUL LN
PHOENIX AZ
85041-8011
US

V. Phone/Fax

Practice location:
  • Phone: 480-825-8477
  • Fax:
Mailing address:
  • Phone: 480-825-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number334517
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: