MEDICARE: MRS. CECILIA ESPINOZA HALLARE FNP-C

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	RN186834	AZ

General Provider Information

NPI Number	:	1588137855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CECILIA ESPINOZA HALLARE FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 37955
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85069-7955
Country	:	US
Telephone Number	:	602-424-4450
Fax Number	:

Provider Business Practice Location Address
First Line	:	2423 W DUNLAP AVE STE 175
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-5823
Country	:	US
Telephone Number	:	602-424-4450
Fax Number	:

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

Provider Enumeration Date	:	01/09/2019
Last Update Date	:	07/30/2024

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