Healthcare Provider Details

I. General information

NPI: 1093972309
Provider Name (Legal Business Name): CYNTHIA GOMEZ SMITH F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CIGI SMITH F.N.P.

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945 W INA RD
TUCSON AZ
85741-2350
US

IV. Provider business mailing address

4001 E SUNRISE DR
TUCSON AZ
85718-4333
US

V. Phone/Fax

Practice location:
  • Phone: 520-219-6616
  • Fax:
Mailing address:
  • Phone: 520-209-7018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP3014
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: