Healthcare Provider Details

I. General information

NPI: 1215048210
Provider Name (Legal Business Name): CHERYL W ROSS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 N LA CHOLLA BLVD STE 277
TUCSON AZ
85741-3564
US

IV. Provider business mailing address

6261 N LA CHOLLA BLVD STE 277
TUCSON AZ
85741-3564
US

V. Phone/Fax

Practice location:
  • Phone: 520-877-3800
  • Fax:
Mailing address:
  • Phone: 520-877-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN059578
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP2494
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP6684
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2494
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: