Healthcare Provider Details

I. General information

NPI: 1689196107
Provider Name (Legal Business Name): ANA LAURA SAENZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 09/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 N LA CHOLLA BLVD
TUCSON AZ
85741-3535
US

IV. Provider business mailing address

5910 N LA CHOLLA BLVD
TUCSON AZ
85741-1378
US

V. Phone/Fax

Practice location:
  • Phone: 520-297-0404
  • Fax:
Mailing address:
  • Phone: 520-297-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP10373
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: