Healthcare Provider Details

I. General information

NPI: 1619328374
Provider Name (Legal Business Name): NUBIA LOMELI DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6524 W INDIAN SCHOOL RD STE A
PHOENIX AZ
85033-3329
US

IV. Provider business mailing address

6524 W INDIAN SCHOOL RD STE A
PHOENIX AZ
85033-3329
US

V. Phone/Fax

Practice location:
  • Phone: 602-892-0799
  • Fax: 602-892-0828
Mailing address:
  • Phone: 602-892-0799
  • Fax: 602-892-0828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8781
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: