Provider Demographics
NPI:1871621284
Name:PACHECO, CHRISTY LEE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LEE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LEE
Other - Last Name:ZANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4710 CAMINO DE LOS VIENTOS
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-0901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2500 N ROSE ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3659
Practice Address - Country:US
Practice Address - Phone:928-213-6100
Practice Address - Fax:928-774-6152
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1985363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP1985OtherLICENSE