Healthcare Provider Details

I. General information

NPI: 1528809928
Provider Name (Legal Business Name): CLAUDIA MEZOH MOPECHA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 N CENTRAL AVE STE 2
PHOENIX AZ
85020-2463
US

IV. Provider business mailing address

9200 N CENTRAL AVE STE 2
PHOENIX AZ
85020-2463
US

V. Phone/Fax

Practice location:
  • Phone: 717-875-7031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05240883
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236749
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: