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General NPI Number Information
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NPI Number | 1871621284
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Entity Type | Individual
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Provider Name | CHRISTY LEE PACHECO FNP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 2500 N ROSE ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-3659
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Country | US
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Telephone | 928-213-6100
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Fax | 928-774-6152
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Provider Business Mailing Address
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Address Line | 4710 CAMINO DE LOS VIENTOS
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-0901
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Country | US
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Telephone |
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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 | AP1985
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License Number State | AZ
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