Healthcare Provider Details

I. General information

NPI: 1831561976
Provider Name (Legal Business Name): PENNY CUFFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 E 18TH ST
TUCSON AZ
85716-5638
US

IV. Provider business mailing address

2745 E 18TH ST
TUCSON AZ
85716-5638
US

V. Phone/Fax

Practice location:
  • Phone: 520-584-4617
  • Fax:
Mailing address:
  • Phone: 520-584-4617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN06905
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: