MEDICARE: MITZY GERALDINE PACHECO NP

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	RNP252406	AZ

General Provider Information

NPI Number	:	1760196851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITZY GERALDINE PACHECO NP

Provider Business Mailing Address
First Line	:	2400 S AVENUE A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7127
Country	:	US
Telephone Number	:	928-336-2000
Fax Number	:	888-631-5150

Provider Business Practice Location Address
First Line	:	2648 S ARABY RD
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85365-7236
Country	:	US
Telephone Number	:	928-877-0400
Fax Number	:

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

Provider Enumeration Date	:	01/12/2023
Last Update Date	:	12/29/2025

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