MEDICARE: DR. MARIA D VAZQUEZ DNP RN LCCE

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	163WX0003X	Inpatient Obstetric Registered Nurse	29439	PR

General Provider Information

NPI Number	:	1851505721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA D VAZQUEZ DNP RN LCCE

Provider Business Mailing Address
First Line	:	4649 N CALLE SANTA CRUZ
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-5127
Country	:	US
Telephone Number	:	407-221-0158
Fax Number	:	407-221-0158

Provider Business Practice Location Address
First Line	:	4649 N CALLE SANTA CRUZ
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-5127
Country	:	US
Telephone Number	:	407-221-0158
Fax Number	:

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	11/06/2024

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