Provider Demographics
NPI:1215590922
Name:AMADOR, MIREYA MONIQUE (FNP)
Entity Type:Individual
Prefix:
First Name:MIREYA
Middle Name:MONIQUE
Last Name:AMADOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E CROYDON PARK RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5792
Mailing Address - Country:US
Mailing Address - Phone:520-696-3438
Mailing Address - Fax:520-888-2347
Practice Address - Street 1:50 E CROYDON PARK RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5792
Practice Address - Country:US
Practice Address - Phone:520-696-3438
Practice Address - Fax:520-888-2347
Is Sole Proprietor?:No
Enumeration Date:2019-04-18
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ224939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily