Provider Demographics
NPI:1821647421
Name:COVARRUBIAS CORREA, ANA EDITH
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:EDITH
Last Name:COVARRUBIAS CORREA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 N 29TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-2017
Mailing Address - Country:US
Mailing Address - Phone:602-574-3261
Mailing Address - Fax:
Practice Address - Street 1:2702 E FLOWER ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7461
Practice Address - Country:US
Practice Address - Phone:602-381-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ223856163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse