Healthcare Provider Details

I. General information

NPI: 1861066847
Provider Name (Legal Business Name): SHERRIE LYNN ESGUERRA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 09/15/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 W LAWLER LOOP
PHOENIX AZ
85083-1695
US

IV. Provider business mailing address

4409 W LAWLER LOOP
PHOENIX AZ
85083-1695
US

V. Phone/Fax

Practice location:
  • Phone: 602-321-1987
  • Fax:
Mailing address:
  • Phone: 602-321-1987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number257216
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: