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Individual

LUPITA ANN WEATHERWAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
3100 N GLASSFORD HILL RD, PRESCOTT VALLEY, AZ 86314-2285
(928) 777-7820
(928) 777-7821
Mailing address
2790 N KINGS HWY W, PRESCOTT VALLEY, AZ 86314-2808
(928) 261-3375

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
248936
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083250
AZ
01
NA
NA
Enumeration date
02/19/2018
Last updated
05/21/2021
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