Provider Demographics
NPI:1679922389
Name:VARELA, ARMANDO (FNP AGACNP ENP)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:VARELA
Suffix:
Gender:M
Credentials:FNP AGACNP ENP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2240
Mailing Address - Country:US
Mailing Address - Phone:928-404-1488
Mailing Address - Fax:
Practice Address - Street 1:3151 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2240
Practice Address - Country:US
Practice Address - Phone:928-404-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9618363LA2100X
AZAP9617363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care