Basic Information
Provider Information
NPI: 1306210364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMES-ZAMORA
FirstName: AMELIA
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1006 E GUADALUPE RD
Address2:  
City: TEMPE
State: AZ
PostalCode: 852833047
CountryCode: US
TelephoneNumber: 4808384296
FaxNumber: 4808201275
Practice Location
Address1: 1006 E GUADALUPE RD
Address2:  
City: TEMPE
State: AZ
PostalCode: 852833047
CountryCode: US
TelephoneNumber: 4808384296
FaxNumber: 4808201275
Other Information
ProviderEnumerationDate: 11/13/2015
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP8144AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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