Healthcare Provider Details

I. General information

NPI: 1902391428
Provider Name (Legal Business Name): MONICA YULIETH HINESTROZA JORDAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE BLDG 2
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

3838 N CAMPBELL AVE BLDG 2 BANNER UNIVERSITY MEDICINE NORTH
TUCSON AZ
85719-1454
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax: 520-626-5183
Mailing address:
  • Phone: 520-694-8888
  • Fax: 520-626-5183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number69700
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: