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NPI 1942059993

NPI 1942059993 : ELIZABETH GRIJALVA APRN-CNP : DOUGLAS, AZ

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General NPI Number Information
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    NPI Number           |    1942059993
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    Entity Type          |    Individual 
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    Provider Name        |    ELIZABETH GRIJALVA APRN-CNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/14/2024
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    Last Update Date     |    09/17/2025
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Provider Practice Location Address
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    Address Line         |    1100 N F AVE 
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    City                 |    DOUGLAS
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    State                |    AZ
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    Zip                  |    85607-1919
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    Country              |    US
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    Telephone            |    520-364-3285
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    Fax                  |    520-364-3378
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Provider Business Mailing Address
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    Address Line         |    1205 N F AVE 
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    City                 |    DOUGLAS
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    State                |    AZ
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    Zip                  |    85607-1920
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    Country              |    US
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    Telephone            |    520-364-1429
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    Fax                  |    520-515-8690
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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       |    230180
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    License Number State |    AZ
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