MEDICARE: MILIJAN ZIVANOV FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	261607	AZ

General Provider Information

NPI Number	:	1225702897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILIJAN ZIVANOV FNP

Provider Business Mailing Address
First Line	:	2400 S AVENUE A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7127
Country	:	US
Telephone Number	:	928-344-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 S PARKVIEW LOOP STE 201
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-5358
Country	:	US
Telephone Number	:	928-336-7846
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	06/10/2025

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Directions to “ MILIJAN ZIVANOV FNP” Practice Location

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