Provider Demographics
NPI:1427720796
Name:ESPINO LAZO, CELIA CAMILA (FNP)
Entity type:Individual
Prefix:MRS
First Name:CELIA
Middle Name:CAMILA
Last Name:ESPINO LAZO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8618 N 35TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-3800
Mailing Address - Country:US
Mailing Address - Phone:602-249-0999
Mailing Address - Fax:602-249-6020
Practice Address - Street 1:8618 N 35TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-3800
Practice Address - Country:US
Practice Address - Phone:602-249-0999
Practice Address - Fax:602-249-6020
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN186035163W00000X
AZRNP272620363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty