Provider Demographics
NPI:1144621913
Name:BIRD, IRENE ARCENAS (NP-C)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:ARCENAS
Last Name:BIRD
Suffix:
Gender:F
Credentials:NP-C
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Other - Credentials:
Mailing Address - Street 1:3530 S VAL VISTA DR STE B105
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7319
Mailing Address - Country:US
Mailing Address - Phone:855-776-7266
Mailing Address - Fax:928-539-5579
Practice Address - Street 1:2060 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6123
Practice Address - Country:US
Practice Address - Phone:928-819-8834
Practice Address - Fax:928-539-5579
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP5185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ977058Medicaid
AZZ195780Medicare Oscar/Certification