Healthcare Provider Details

I. General information

NPI: 1417428657
Provider Name (Legal Business Name): LIDIA MARGARITA NAVARRO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13755 N LITCHFIELD RD STE 105
SURPRISE AZ
85379-4288
US

IV. Provider business mailing address

13755 N LITCHFIELD RD STE 105
SURPRISE AZ
85379-4288
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-5900
  • Fax:
Mailing address:
  • Phone: 623-322-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11509
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: