=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881987261
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NIKOLINA V ELEZ FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2011
-----------------------------------------------------
Last Update Date | 08/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1205 S 7TH AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85007-3913
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-344-6600
-----------------------------------------------------
Fax | 602-344-6601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2700 N CENTRAL AVE STE 1050
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85004-1217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-266-8402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN139674
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------