Botello, Gina
Botello, Gina is an sole proprietor health care provider with primary practice located at 2851 S Avenue B Bldg 19 , Yuma AZ 85364-7726. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Botello, Gina can be contacted via phone (928) 336-2090.Contact Information
Primary practice address
2851 S Avenue B Bldg 19
Yuma AZ 85364-7726
Phone: (928) 336-2090
Fax: (928) 722-6113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP5180 | Arizona |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | AP5180 | Arizona |
Profile Details
| NPI number | 1770917429 |
|---|---|
| LBN Legal business name | Botello, Gina |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2013 |
| Last updated | Nov 15th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770917429 | NPPES |
| Arizona | MEDICAID | 004882 | |
| Arizona | Other | Z176616 |
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