Provider Demographics
NPI:1669943387
Name:BOTSIOS, EMILY C (CNM)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:BOTSIOS
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:530 E THOMAS ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3204
Mailing Address - Country:US
Mailing Address - Phone:860-678-3402
Mailing Address - Fax:844-364-3181
Practice Address - Street 1:3815 S. VAL VISTA DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7308
Practice Address - Country:US
Practice Address - Phone:480-782-0993
Practice Address - Fax:833-337-0386
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2022-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZRN133645367A00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife