Healthcare Provider Details

I. General information

NPI: 1235769431
Provider Name (Legal Business Name): REBECCA HEGARTY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N ALVERNON WAY
TUCSON AZ
85711-1827
US

IV. Provider business mailing address

9925 E PASEO JUAN TABO
TUCSON AZ
85747-9131
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax:
Mailing address:
  • Phone: 520-990-3798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number236630
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: