Healthcare Provider Details

I. General information

NPI: 1427720796
Provider Name (Legal Business Name): CELIA CAMILA ESPINO LAZO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 465
PHOENIX AZ
85037-3357
US

IV. Provider business mailing address

9305 W THOMAS RD STE 465
PHOENIX AZ
85037-3357
US

V. Phone/Fax

Practice location:
  • Phone: 480-745-3547
  • Fax: 480-745-3548
Mailing address:
  • Phone: 480-745-3547
  • Fax: 480-745-3548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNP272620
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN186035
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: