Provider Demographics
NPI:1588137855
Name:HALLARE, CECILIA ESPINOZA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:ESPINOZA
Last Name:HALLARE
Suffix:
Gender:F
Credentials: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:PO BOX 37955
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-7955
Mailing Address - Country:US
Mailing Address - Phone:602-424-4450
Mailing Address - Fax:
Practice Address - Street 1:2423 W DUNLAP AVE STE 175
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-5823
Practice Address - Country:US
Practice Address - Phone:602-424-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN186834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily