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NPI 1396441762

NPI 1396441762 : HOLLY ANN VALDEZ : SURPRISE, AZ

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General NPI Number Information
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    NPI Number           |    1396441762
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    Entity Type          |    Individual 
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    Provider Name        |    HOLLY ANN VALDEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/06/2023
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    Last Update Date     |    02/13/2023
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Provider Practice Location Address
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    Address Line         |    18911 W SIERRA ST 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85388-3245
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    Country              |    US
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    Telephone            |    602-469-6875
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    18911 W SIERRA ST 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85388-3245
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    Country              |    US
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    Telephone            |    602-469-6875
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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       |    287578
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    License Number State |    AZ
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