Provider Demographics
NPI:1720698293
Name:ELIZALDE, HELENE (MSN, APRN-FNP)
Entity Type:Individual
Prefix:MRS
First Name:HELENE
Middle Name:
Last Name:ELIZALDE
Suffix:
Gender:F
Credentials:MSN, APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21772 S ELLSWORTH LOOP RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7709
Mailing Address - Country:US
Mailing Address - Phone:480-512-3700
Mailing Address - Fax:480-512-3715
Practice Address - Street 1:21772 S ELLSWORTH LOOP RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-7709
Practice Address - Country:US
Practice Address - Phone:480-512-3700
Practice Address - Fax:480-512-3715
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-08
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ245945363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily