Healthcare Provider Details

I. General information

NPI: 1043210057
Provider Name (Legal Business Name): DEBORAH RUTH HOTEP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 N LA CHOLLA BLVD
TUCSON AZ
85741-3557
US

IV. Provider business mailing address

5095 N GERHART RD
TUCSON AZ
85745-9295
US

V. Phone/Fax

Practice location:
  • Phone: 520-731-1110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30006889
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2347
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: