Healthcare Provider Details

I. General information

NPI: 1811819329
Provider Name (Legal Business Name): TAWNY MARIE GARCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16872 W HAMMOND ST
GOODYEAR AZ
85338-7440
US

IV. Provider business mailing address

16872 W HAMMOND ST
GOODYEAR AZ
85338-7440
US

V. Phone/Fax

Practice location:
  • Phone: 602-354-0689
  • Fax:
Mailing address:
  • Phone: 602-354-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2026040709
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: