Provider Demographics
NPI:1194485102
Name:BELTRAN PEREZ, ADALBERTO (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:ADALBERTO
Middle Name:
Last Name:BELTRAN PEREZ
Suffix:
Gender:M
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7127
Mailing Address - Country:US
Mailing Address - Phone:928-344-2000
Mailing Address - Fax:928-342-3850
Practice Address - Street 1:11142 S SCOTTSDALE DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-5616
Practice Address - Country:US
Practice Address - Phone:928-336-1815
Practice Address - Fax:928-342-3850
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-19
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ267904363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty