Healthcare Provider Details

I. General information

NPI: 1104790476
Provider Name (Legal Business Name): LORI ESCOBEDO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1853 N KOLB RD
TUCSON AZ
85715-4900
US

IV. Provider business mailing address

9896 N HACIENDA HERMOSA DR
ORO VALLEY AZ
85737-3647
US

V. Phone/Fax

Practice location:
  • Phone: 520-624-1600
  • Fax:
Mailing address:
  • Phone: 520-624-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number090790
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: