Healthcare Provider Details

I. General information

NPI: 1528580974
Provider Name (Legal Business Name): GINA MARIE TOME FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20201 N SCOTTSDALE HEALTHCARE DR STE 145
SCOTTSDALE AZ
85255-4136
US

IV. Provider business mailing address

20201 N SCOTTSDALE HEALTHCARE DR STE 145
SCOTTSDALE AZ
85255-4136
US

V. Phone/Fax

Practice location:
  • Phone: 480-748-7788
  • Fax: 480-591-9774
Mailing address:
  • Phone: 480-748-7788
  • Fax: 480-591-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10294
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: