Healthcare Provider Details

I. General information

NPI: 1518122761
Provider Name (Legal Business Name): IVORYHALL FIRST ASSISTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2008
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 W RUDASILL RD
TUCSON AZ
85741-3439
US

IV. Provider business mailing address

2770 W RUDASILL RD
TUCSON AZ
85741-3439
US

V. Phone/Fax

Practice location:
  • Phone: 520-488-3626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: SUE WEEKLEY
Title or Position: MEMBER
Credential:
Phone: 520-488-3626