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General NPI Number Information
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NPI Number | 1073943825
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Entity Type | Individual
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Provider Name | EVA SOCORRO MIJARES FNP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 410 E MC 85
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City | BUCKEYE
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State | AZ
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Zip | 85326
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Country | US
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Telephone | 602-363-3438
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Fax | 602-584-3677
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Provider Business Mailing Address
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Address Line | 1216 S 111TH DR UNIT 1087
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City | CASHION
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State | AZ
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Zip | 85329-7074
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Country | US
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Telephone | 602-399-3941
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Fax | 602-584-3677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN128794
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP5336
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License Number State | AZ
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