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General NPI Number Information
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NPI Number | 1235995853
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Entity Type | Individual
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Provider Name | MARIYAH MARISELLA BEJARANO FNP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1300 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-3301
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Country | US
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Telephone | 928-428-3122
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Fax | 928-428-7917
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Provider Business Mailing Address
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Address Line | 1300 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546-3301
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Country | US
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Telephone | 928-428-3122
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Fax | 928-428-7917
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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 | 304177
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License Number State | AZ
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