Healthcare Provider Details

I. General information

NPI: 1124668728
Provider Name (Legal Business Name): RAQUEL R. RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 W INA RD # 101
TUCSON AZ
85704-1928
US

IV. Provider business mailing address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

V. Phone/Fax

Practice location:
  • Phone: 520-797-8555
  • Fax: 520-575-1566
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number235934
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: