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General NPI Number Information
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NPI Number | 1164059077
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Entity Type | Individual
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Provider Name | VIRGINIA RAGONESE-GREEN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 3814 E 5TH ST
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City | TUCSON
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State | AZ
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Zip | 85716-5145
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Country | US
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Telephone | 520-372-8575
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Fax | 520-372-8576
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Provider Business Mailing Address
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Address Line | 4544 N ROCKCLIFF RD
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City | TUCSON
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State | AZ
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Zip | 85750-9782
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Country | US
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Telephone | 520-403-2458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN116360
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 247210
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License Number State | AZ
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