Healthcare Provider Details

I. General information

NPI: 1871573873
Provider Name (Legal Business Name): MARCEE BUSHFIELD-KAHAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 E FORT LOWELL RD
TUCSON AZ
85705-3920
US

IV. Provider business mailing address

137 E FORT LOWELL RD
TUCSON AZ
85705-3920
US

V. Phone/Fax

Practice location:
  • Phone: 520-888-2435
  • Fax: 520-888-7618
Mailing address:
  • Phone: 520-888-2435
  • Fax: 520-888-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN085314
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: