MEDICARE: ELISA HEDRICK APRN

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	363L00000X	Nurse Practitioner	306476	AZ

General Provider Information

NPI Number	:	1366376238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA HEDRICK APRN

Provider Business Mailing Address
First Line	:	4081 W CAMILLE PL
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-6093
Country	:	US
Telephone Number	:	864-384-6202
Fax Number	:

Provider Business Practice Location Address
First Line	:	284 W 32ND ST
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8152
Country	:	US
Telephone Number	:	928-431-4563
Fax Number	:

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ ELISA HEDRICK APRN” Practice Location

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