Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP3506 | AZ |
NPI | 1003135898 |
---|---|
Provider Name | Mrs. Hazel Echavez Mercado |
First Address | Tucson, AZ 85747-9664 |
Second Address | Tucson, AZ 85747-9664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 17/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003135898 | NPI (01) | AZ |
2009004073 | AMERICAN NURSES CREDENTIALING CENTER (ANCC) (01) | AZ |
52739 | (05) | AZ |
AP3506 | CERTIFICATE OF ADVANCE NURSE PRACTICE AS FAMILY NURSE PRACTITIONER (01) | AZ |