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General NPI Number Information
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NPI Number | 1366907602
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Entity Type | Individual
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Provider Name | JOHN PAULO BATUCAN BAUTISTA DNP, APRN, AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 4515 S MCCLINTOCK DR STE 120
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City | TEMPE
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State | AZ
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Zip | 85282-7381
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Country | US
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Telephone | 480-704-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 525 W BROWN RD FL 7
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City | MESA
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State | AZ
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Zip | 85201-3202
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Country | US
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Telephone | 480-684-8350
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN165012
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP11735
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License Number State | AZ
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