Healthcare Provider Details

I. General information

NPI: 1679922389
Provider Name (Legal Business Name): ARMANDO VARELA FNP AGACNP ENP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 N WINDSONG DR
PRESCOTT VALLEY AZ
86314-1222
US

IV. Provider business mailing address

3251 N WINDSONG DR
PRESCOTT VALLEY AZ
86314-1222
US

V. Phone/Fax

Practice location:
  • Phone: 928-772-2582
  • Fax: 877-319-1729
Mailing address:
  • Phone: 928-772-2582
  • Fax: 877-319-1729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9617
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP9618
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: