Healthcare Provider Details

I. General information

NPI: 1184276040
Provider Name (Legal Business Name): MAUREEN RITA BAY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 03/14/2020
Certification Date: 03/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 E WILCOX DR
SIERRA VISTA AZ
85635-2843
US

IV. Provider business mailing address

1521 E TANGERINE RD STE 201
ORO VALLEY AZ
85755-6218
US

V. Phone/Fax

Practice location:
  • Phone: 520-229-2080
  • Fax: 520-229-2092
Mailing address:
  • Phone: 520-526-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226026
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: