Lucila Yareth Medina Gonzalez, RN
Individual provider Active NPI Registered Nurse · Somerton, AZ
NPI 1235908310 · NPPES record last updated Dec 29, 2023
Key facts
- NPI
- 1235908310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 238829 (AZ)
- Practice address
- 834 W. Calle Nueva Vida
Somerton, AZ 85350 - Phone
- (928) 817-9419
- NPI assigned
- Dec 29, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238829 | AZ | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 238829 | AZ | Yes |
Addresses
Primary practice location
834 W. Calle Nueva Vida
Somerton, AZ 85350
Mailing address
PO Box 2602
Somerton, AZ 85350-2602
Phone (928) 817-9419
Other providers in Somerton, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.