Provider Demographics
NPI:1619328374
Name:LOMELI, NUBIA (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:NUBIA
Middle Name:
Last Name:LOMELI
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6524 W INDIAN SCHOOL RD STE A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-3329
Mailing Address - Country:US
Mailing Address - Phone:602-892-0799
Mailing Address - Fax:602-892-0828
Practice Address - Street 1:6524 W INDIAN SCHOOL RD STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-3329
Practice Address - Country:US
Practice Address - Phone:602-892-0799
Practice Address - Fax:602-892-0828
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8781363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ166038Medicaid