Provider Demographics
NPI:1073943825
Name:MIJARES, EVA SOCORRO (FNP)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:SOCORRO
Last Name:MIJARES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1216 S 111TH DR UNIT 1087
Mailing Address - Street 2:
Mailing Address - City:CASHION
Mailing Address - State:AZ
Mailing Address - Zip Code:85329-7074
Mailing Address - Country:US
Mailing Address - Phone:602-399-3941
Mailing Address - Fax:602-584-3677
Practice Address - Street 1:410 E MC 85
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326
Practice Address - Country:US
Practice Address - Phone:602-363-3438
Practice Address - Fax:602-584-3677
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP5336363LF0000X
AZRN128794163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse