Provider Demographics
NPI:1982048864
Name:ESCOBAR, BERTHA ELENA (APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:ELENA
Last Name:ESCOBAR
Suffix:
Gender:
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37100 N GANTZEL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7352
Mailing Address - Country:US
Mailing Address - Phone:480-394-4469
Mailing Address - Fax:480-394-4520
Practice Address - Street 1:37100 N GANTZEL RD STE 201
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-7352
Practice Address - Country:US
Practice Address - Phone:480-384-4469
Practice Address - Fax:480-394-4520
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ318924363LF0000X
IL209010284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily