Healthcare Provider Details

I. General information

NPI: 1225728934
Provider Name (Legal Business Name): ADRIAN ESCARCEGA FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 06/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14510 W SHUMWAY DR STE 201
SUN CITY WEST AZ
85375-5817
US

IV. Provider business mailing address

14510 W SHUMWAY DR STE 201
SUN CITY WEST AZ
85375-5817
US

V. Phone/Fax

Practice location:
  • Phone: 623-444-6463
  • Fax:
Mailing address:
  • Phone: 623-444-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number291426
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: