Provider Demographics
NPI:1912754219
Name:VERDY, ESMERALDA DE LA ROSA (CLD, CBE)
Entity type:Individual
Prefix:
First Name:ESMERALDA
Middle Name:DE LA ROSA
Last Name:VERDY
Suffix:
Gender:F
Credentials:CLD, CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11412 W DANA LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-3439
Mailing Address - Country:US
Mailing Address - Phone:623-282-7874
Mailing Address - Fax:
Practice Address - Street 1:11412 W DANA LN
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-3439
Practice Address - Country:US
Practice Address - Phone:623-282-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4788374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula