Provider Demographics
NPI:1538292347
Name:GONZALEZ, ELIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3605
Mailing Address - Country:US
Mailing Address - Phone:928-502-7879
Mailing Address - Fax:928-502-7879
Practice Address - Street 1:1201 W 12TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3605
Practice Address - Country:US
Practice Address - Phone:928-502-7879
Practice Address - Fax:928-502-7879
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN124881163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool