Provider Demographics
NPI:1598481863
Name:PEDROSA, DAISY (MSN, APRN-RNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:PEDROSA
Suffix:
Gender:F
Credentials:MSN, APRN-RNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16216 W MOHAVE ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7952
Mailing Address - Country:US
Mailing Address - Phone:602-327-7047
Mailing Address - Fax:
Practice Address - Street 1:16216 W MOHAVE ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7952
Practice Address - Country:US
Practice Address - Phone:602-327-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ281865363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty