Healthcare Provider Details

I. General information

NPI: 1740652791
Provider Name (Legal Business Name): NICHOLAS JOHN PACIONE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N LA CHOLLA BLVD
TUCSON AZ
85741-3529
US

IV. Provider business mailing address

7318 LINCOLN ESTATES DR
YAKIMA WA
98908-5419
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-9000
  • Fax:
Mailing address:
  • Phone: 509-208-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019468
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1052894
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11040057
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA1410
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0992116-CRNA
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP61407987
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: