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General NPI Number Information
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NPI Number | 1134991680
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Entity Type | Individual
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Provider Name | NORMA IRENE ERIVEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1298 W FINNIE FLAT RD
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City | CAMP VERDE
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State | AZ
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Zip | 86322-5958
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Country | US
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Telephone | 928-639-5555
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Fax | 928-639-5554
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Provider Business Mailing Address
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Address Line | 3295 VALLEY VISTA DR
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City | SEDONA
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State | AZ
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Zip | 86351-7218
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Country | US
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Telephone | 602-821-1339
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 299356
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License Number State | AZ
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