Healthcare Provider Details

I. General information

NPI: 1437601218
Provider Name (Legal Business Name): ADRIANNA BERNAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 E HAMPTON ST
TUCSON AZ
85712-2919
US

IV. Provider business mailing address

5550 E HAMPTON ST
TUCSON AZ
85712-2919
US

V. Phone/Fax

Practice location:
  • Phone: 520-721-8605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN167378
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number219931
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: