Provider Demographics
NPI:1528479524
Name:SANCHEZ, SHIRLEY CORTEZ
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:CORTEZ
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 MATSUMOTO ST
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-1491
Mailing Address - Country:US
Mailing Address - Phone:520-396-9024
Mailing Address - Fax:
Practice Address - Street 1:1051 MATSUMOTO ST
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-1491
Practice Address - Country:US
Practice Address - Phone:520-396-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ879374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide