Healthcare Provider Details

I. General information

NPI: 1902574817
Provider Name (Legal Business Name): LINDSY NUNGARAY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 S 8TH AVE
YUMA AZ
85364-7110
US

IV. Provider business mailing address

1134 S HEREFORD AVE
YUMA AZ
85364-3302
US

V. Phone/Fax

Practice location:
  • Phone: 928-341-0700
  • Fax: 928-341-0900
Mailing address:
  • Phone: 951-282-5286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number263416
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: