Healthcare Provider Details

I. General information

NPI: 1669204558
Provider Name (Legal Business Name): TAMARA GRZYBOWSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W WETMORE RD
TUCSON AZ
85705-1547
US

IV. Provider business mailing address

701 W WETMORE RD
TUCSON AZ
85705-1547
US

V. Phone/Fax

Practice location:
  • Phone: 520-696-5234
  • Fax: 520-696-5067
Mailing address:
  • Phone: 520-696-5234
  • Fax: 520-696-5067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number230272
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: