Individual
MR. IVAN HORACIO VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
100 E. 24TH ST SUITE 3A, YUMA, AZ 85364
(928) 750-6410
(928) 750-6433
Mailing address
100 E 24TH ST STE 3A, YUMA, AZ 85364-8620
(928) 750-6410
(928) 750-6433
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN185788
AZ
363LF0000X
Family Nurse Practitioner
Primary
268101
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105456
—
AZ
Enumeration date
10/26/2021
Last updated
01/29/2026
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