Healthcare Provider Details

I. General information

NPI: 1376315978
Provider Name (Legal Business Name): BECKY B VINCENTI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N ROSEMONT BLVD
TUCSON AZ
85712-2139
US

IV. Provider business mailing address

PO BOX 81064
CLEVELAND OH
44181-0064
US

V. Phone/Fax

Practice location:
  • Phone: 520-795-8080
  • Fax: 520-323-6237
Mailing address:
  • Phone: 520-795-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number226630
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: