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General NPI Number Information
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NPI Number | 1205530441
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Entity Type | Organization
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Legal Business Name | WKK2MED PLLC
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 1200 N EL DORADO PL STE I910
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City | TUCSON
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State | AZ
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Zip | 85715-4637
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Country | US
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Telephone | 520-324-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 9384 E MYRA DR
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City | TUCSON
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State | AZ
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Zip | 85730-2940
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Country | US
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Telephone | 520-906-1940
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Fax | 520-733-2580
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Authorized Official
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Title or Position | OWNER
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Name | MR. WAYNE C MCLEOD
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Credential | FNP
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Telephone | 520-906-1940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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