Healthcare Provider Details

I. General information

NPI: 1821795626
Provider Name (Legal Business Name): MACELINE CHECK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3295 W INA RD STE 150
TUCSON AZ
85741-2192
US

IV. Provider business mailing address

1161 N EL DORADO PL STE 203
TUCSON AZ
85715-4607
US

V. Phone/Fax

Practice location:
  • Phone: 207-444-3765
  • Fax:
Mailing address:
  • Phone: 520-570-1460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License Number1073322
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number290143
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number67107
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number290143
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: