Healthcare Provider Details

I. General information

NPI: 1922089622
Provider Name (Legal Business Name): F BETH ORENDUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 E PARADISE FALLS DR SUITE 201
TUCSON AZ
85712-6687
US

IV. Provider business mailing address

3411 N 5TH AVE STE 209
PHOENIX AZ
85013-3812
US

V. Phone/Fax

Practice location:
  • Phone: 520-615-6200
  • Fax: 520-615-6255
Mailing address:
  • Phone: 602-789-0344
  • Fax: 602-870-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberAP1506
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP1506
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: