Healthcare Provider Details

I. General information

NPI: 1972827178
Provider Name (Legal Business Name): GINA MARIE TIZIO N.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTHERN AVE STE G
TEMPE AZ
85282-7695
US

IV. Provider business mailing address

2600 E SOUTHERN AVE STE G
TEMPE AZ
85282-7695
US

V. Phone/Fax

Practice location:
  • Phone: 480-357-6275
  • Fax:
Mailing address:
  • Phone: 480-357-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number101181
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: