Provider Demographics
NPI:1639539513
Name:ORTEGA, GUADALUPE (APRN,ACNP-BC, FNP-BC)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:APRN,ACNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 CAMINO CHOLULA
Mailing Address - Street 2:
Mailing Address - City:RIO RICO
Mailing Address - State:AZ
Mailing Address - Zip Code:85648-1029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6565 E CARONDELET DR STE 155
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3587
Practice Address - Country:US
Practice Address - Phone:520-849-8900
Practice Address - Fax:520-849-7137
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7697208800000X, 363LA2100X
AZAP11664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No208800000XAllopathic & Osteopathic PhysiciansUrology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily