Provider Demographics
NPI:1558143099
Name:ESPIRITU LOPEZ, SHIARA PATRICIA (NP)
Entity Type:Individual
Prefix:
First Name:SHIARA
Middle Name:PATRICIA
Last Name:ESPIRITU LOPEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 N 85TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4161
Mailing Address - Country:US
Mailing Address - Phone:480-200-0217
Mailing Address - Fax:
Practice Address - Street 1:1046 N 85TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-4161
Practice Address - Country:US
Practice Address - Phone:480-200-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ217803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty