Healthcare Provider Details

I. General information

NPI: 1659092377
Provider Name (Legal Business Name): OMNIA H ELIAS BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 N MARTIN AVE
TUCSON AZ
85721-0001
US

IV. Provider business mailing address

1305 N MARTIN AVE
TUCSON AZ
85721-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-6154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: