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General NPI Number Information
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NPI Number | 1366420648
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Entity Type | Individual
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Provider Name | MARTHA LIZARRAGA DE GARZA FNP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 695 S PECAN TREE LN
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5114
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Country | US
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Telephone | 520-625-8116
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Fax | 520-625-0224
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 520-625-8116
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Fax | 520-625-0224
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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 | RN075113
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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 | AP2140
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License Number State | AZ
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