Basic Information
| Provider Information | |||||||||
| NPI: | 1649882929 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENDOZA EALY | ||||||||
| FirstName: | NAOMI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5697 RATTLESNAKE SPRINGS RD UNIT A | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799064170 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1305 N MARTIN AVE | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857210001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206266254 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2020 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 144243 | AZ | Y | Nursing Service Providers | Registered Nurse |
No ID Information.