Provider Demographics
NPI:1245967041
Name:BRITO ELIZARDEZ, YELINA (PA)
Entity type:Individual
Prefix:
First Name:YELINA
Middle Name:
Last Name:BRITO ELIZARDEZ
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WILLIAM ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4661
Mailing Address - Country:US
Mailing Address - Phone:505-768-5450
Mailing Address - Fax:
Practice Address - Street 1:1401 WILLIAM ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4661
Practice Address - Country:US
Practice Address - Phone:505-768-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant