Healthcare Provider Details

I. General information

NPI: 1295423093
Provider Name (Legal Business Name): YESENIA ESCALANTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 W 27TH ST STE 1
YUMA AZ
85364-7207
US

IV. Provider business mailing address

3510 W 17TH PL
YUMA AZ
85364-4976
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-8400
  • Fax:
Mailing address:
  • Phone: 928-287-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRNP291070
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: