Healthcare Provider Details

I. General information

NPI: 1174990949
Provider Name (Legal Business Name): ANDREA ESCALANTE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3910 E 22ND ST
TUCSON AZ
85711-5333
US

IV. Provider business mailing address

1055 W COLUMBIA ST
TUCSON AZ
85714-1133
US

V. Phone/Fax

Practice location:
  • Phone: 855-925-4733
  • Fax:
Mailing address:
  • Phone: 520-730-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTAP7870
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: