Healthcare Provider Details

I. General information

NPI: 1487930871
Provider Name (Legal Business Name): KIRK TJALAS FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KIRK ALAN TJALAS FNP-BC,PMHNP

II. Dates (important events)

Enumeration Date: 10/29/2011
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7620 N HARTMAN LN STE 180
TUCSON AZ
85743-7485
US

IV. Provider business mailing address

7620 N HARTMAN LN STE 180
TUCSON AZ
85743-7485
US

V. Phone/Fax

Practice location:
  • Phone: 520-689-6814
  • Fax: 866-740-4777
Mailing address:
  • Phone: 520-345-0443
  • Fax: 866-531-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number234051
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10028304
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number607851
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number815057
License Number StateNV
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number234051
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: