Healthcare Provider Details

I. General information

NPI: 1760346779
Provider Name (Legal Business Name): CYNTHIA WATTERS BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4729 E SUNRISE DR STE 458
TUCSON AZ
85718-4534
US

IV. Provider business mailing address

4729 E SUNRISE DR STE 458
TUCSON AZ
85718-4534
US

V. Phone/Fax

Practice location:
  • Phone: 520-323-5910
  • Fax: 520-220-5595
Mailing address:
  • Phone: 520-323-5910
  • Fax: 520-220-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN040324
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: