Healthcare Provider Details

I. General information

NPI: 1639033152
Provider Name (Legal Business Name): TRACI LYNE TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 E LOWELL ST
TUCSON AZ
85721-0400
US

IV. Provider business mailing address

1224 E LOWELL ST
TUCSON AZ
85721-0400
US

V. Phone/Fax

Practice location:
  • Phone: 520-621-6493
  • Fax: 520-626-4301
Mailing address:
  • Phone: 520-621-6493
  • Fax: 520-626-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN121624
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: