Provider Demographics
NPI:1417301318
Name:ESPERAS, AMANDA KAI-LAI (DNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KAI-LAI
Last Name:ESPERAS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 E CAMELBACK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2327
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-1784
Practice Address - Fax:602-933-4298
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8590363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20180441OtherPEDIATRIC NURSING CERTIFICATION BOARD
AZ20160888OtherPEDIATRIC NURSING CERTIFICATION BOARD
AZAP8590OtherARIZONA STATE BOARD OF NURSING, ADVANCED PRACTICE NURSE
AZRN168953OtherARIZONA STATE BOARD OF NURSING