Healthcare Provider Details

I. General information

NPI: 1457098634
Provider Name (Legal Business Name): MARIA-LUZ SOTOMAYOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA LUZ SOTOMAYOR

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 E SHOW LOW LAKE RD STE 1
SHOW LOW AZ
85901-7955
US

IV. Provider business mailing address

2650 E SHOW LOW LAKE RD STE 1
SHOW LOW AZ
85901-7955
US

V. Phone/Fax

Practice location:
  • Phone: 928-537-4300
  • Fax: 928-532-6901
Mailing address:
  • Phone: 928-537-4300
  • Fax: 928-532-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number271023
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: