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NPI Code Detail

MEDICARE: MS. ANDREA MARIA COLUSSY N.P.

MEDICARE: MS. ANDREA MARIA COLUSSY N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN035844AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2WA536164213OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1463076OTHERAZAHCCCS

General Provider Information

NPI Number : 1700842630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA MARIA COLUSSY N.P.
Provider Business Mailing Address
First Line : PO BOX 36627
Second Line :
City : TUCSON
State : AZ
Zip : 85740-6627
Country : US
Telephone Number : 520-297-8429
Fax Number : 520-989-3486
Provider Business Practice Location Address
First Line : 2001 W ORANGE GROVE RD STE 312
Second Line :
City : TUCSON
State : AZ
Zip : 85704-1141
Country : US
Telephone Number : 520-297-8429
Fax Number : 520-989-3486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 01/08/2013

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Directions to “ MS. ANDREA MARIA COLUSSY N.P.” Practice Location

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