=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134371917
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALBERTA DIANE ESPINOZA-LYONS FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2008
-----------------------------------------------------
Last Update Date | 05/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | US 191 & AZ 264
-----------------------------------------------------
City | GANADO
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-755-4632
-----------------------------------------------------
Fax | 928-755-4831
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4141 TOWNSHIP ROAD 223 SE
-----------------------------------------------------
City | NEW LEXINGTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-342-4334
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN260365
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 10303 NP
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 320378
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------