Healthcare Provider Details

I. General information

NPI: 1609561109
Provider Name (Legal Business Name): JASMINE ROSE PEREIRA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7089 N THORNYDALE RD STE 101
TUCSON AZ
85741-2728
US

IV. Provider business mailing address

7570 S MALCOLM AVE
TUCSON AZ
85746-2529
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-1016
  • Fax:
Mailing address:
  • Phone: 520-603-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRNP342921
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN209332
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: