Healthcare Provider Details

I. General information

NPI: 1154824233
Provider Name (Legal Business Name): TIFFANY LYNCH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date: 06/25/2019
Reactivation Date: 09/02/2021

III. Provider practice location address

7900 S J STOCK RD
TUCSON AZ
85746-7012
US

IV. Provider business mailing address

7900 S J STOCK RD
TUCSON AZ
85746-7012
US

V. Phone/Fax

Practice location:
  • Phone: 520-295-2511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number150138
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: