Provider Demographics
NPI:1154771509
Name:YTUARTE, SOFHIA YNES (DNP, PNP-PC)
Entity type:Individual
Prefix:
First Name:SOFHIA
Middle Name:YNES
Last Name:YTUARTE
Suffix:
Gender:F
Credentials:DNP, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8174 S WOODFROST WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9014
Mailing Address - Country:US
Mailing Address - Phone:520-909-3209
Mailing Address - Fax:
Practice Address - Street 1:535 N WILMOT RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2683
Practice Address - Country:US
Practice Address - Phone:520-694-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8744363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics