Healthcare Provider Details

I. General information

NPI: 1457604506
Provider Name (Legal Business Name): MARTHA VERONICA BORBON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 E PASEO CELESTIAL
SAHUARITA AZ
85629-8880
US

IV. Provider business mailing address

246 E PASEO CELESTIAL
SAHUARITA AZ
85629-8880
US

V. Phone/Fax

Practice location:
  • Phone: 520-313-7633
  • Fax:
Mailing address:
  • Phone: 520-313-7633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4647
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: