Healthcare Provider Details

I. General information

NPI: 1972418986
Provider Name (Legal Business Name): MY HOMETOWN NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 GOLD RUSH WAY
CHINO VALLEY AZ
86323-5864
US

IV. Provider business mailing address

433 GOLD RUSH WAY
CHINO VALLEY AZ
86323-5864
US

V. Phone/Fax

Practice location:
  • Phone: 480-206-0647
  • Fax:
Mailing address:
  • Phone: 480-206-0647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMMY TUNIS
Title or Position: OWNER/PROVIDER
Credential: FNP
Phone: 480-206-0647