Healthcare Provider Details

I. General information

NPI: 1225467723
Provider Name (Legal Business Name): JONATHAN ADIN SINNOTT NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 N SAN DIEGO ST
TOMBSTONE AZ
85638-0406
US

IV. Provider business mailing address

7 N SAN DIEGO ST
TOMBSTONE AZ
85638-0406
US

V. Phone/Fax

Practice location:
  • Phone: 520-432-6460
  • Fax: 520-457-1485
Mailing address:
  • Phone: 520-432-6460
  • Fax: 520-457-1485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN 66439
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237496
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNRN233262
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAZNP237496
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN233262
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: