Provider Demographics
NPI:1700607884
Name:TEJADA, ANA ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ELIZABETH
Last Name:TEJADA
Suffix:
Gender:F
Credentials:RN
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 12632
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-2632
Mailing Address - Country:US
Mailing Address - Phone:310-910-7038
Mailing Address - Fax:
Practice Address - Street 1:8738 E VOLTAIRE AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-4128
Practice Address - Country:US
Practice Address - Phone:310-910-7038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN128302163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care