Healthcare Provider Details

I. General information

NPI: 1174316038
Provider Name (Legal Business Name): KARLA QUEREN PEREGRINA APRN-RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 17513
TUCSON AZ
85731-7513
US

IV. Provider business mailing address

PO BOX 17513
TUCSON AZ
85731-7513
US

V. Phone/Fax

Practice location:
  • Phone: 520-395-1593
  • Fax:
Mailing address:
  • Phone: 520-395-1593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number342416
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: