Provider Type Icon

GINA BOTELLO FNP NPI 1770917429


NPI Information

NPI: 1770917429
Provider Name: GINA BOTELLO, FNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1896 E BABBIT LN
SAN LUIS, AZ
ZIP 85349
Phone: (928) 722-6112
Get Directions

Gina Botello, FNP is a psychiatric/mental health nurse practitioner in San Luis, AZ with 5 years of experience. Gina Botello, FNP NPI is 1770917429. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1896 E BABBIT LN
SAN LUIS, AZ
ZIP 85349
Phone: (928) 722-6112
Fax: (928) 722-6113

The NPI 1770917429 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation (HCPCS:90791)

The enumeration date for this NPI number is 8/29/2013 and was last updated on 12/23/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAP5180ARIZONANo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAP5180ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1004882MEDICAIDARIZONA
2Z176616OTHERARIZONAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.