Provider Demographics
NPI:1912943374
Name:YPARRAGUIRRE, ALICE O (APRN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:O
Last Name:YPARRAGUIRRE
Suffix:
Gender:F
Credentials:APRN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:
Practice Address - Street 1:16435 N SCOTTSDALE RD STE 285
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1680
Practice Address - Country:US
Practice Address - Phone:480-573-6436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3750363L00000X
CO0101958363L00000X
OR10025714363L00000X
AZRN106017 / AP2166363LA2200X
AZAP2166363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ119702Medicare PIN