Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP4904 | AZ |
NPI | 1043644941 |
---|---|
Provider Name | Elia Valdivia |
First Address | Scottsdale, AZ 85251-6900 |
Second Address | Scottsdale, AZ 85258-4585 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2013 |
Last Update Date | 06/11/2019 |