Individual
ELIZABETH VIDALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C
Contact information
Practice address
306 E MONROE AVE, BUCKEYE, AZ 85326-2706
(877) 809-5092
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(623) 583-3001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220228
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467628
—
AZ
Enumeration date
12/27/2018
Last updated
02/18/2025
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