Healthcare Provider Details

I. General information

NPI: 1396719233
Provider Name (Legal Business Name): ANGELITA CRYSTAL ZECHMAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20601 N 19TH AVE STE 130
PHOENIX AZ
85027-3587
US

IV. Provider business mailing address

20601 N 19TH AVE STE 130
PHOENIX AZ
85027-3587
US

V. Phone/Fax

Practice location:
  • Phone: 480-862-1700
  • Fax:
Mailing address:
  • Phone: 480-862-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR236714
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008523
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: