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General NPI Number Information
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NPI Number | 1477551109
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Entity Type | Individual
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Provider Name | WAYNE C. MCLEOD APRN-BC
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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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 | 520-318-3004
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Fax | 520-318-3061
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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 | 520-318-3004
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Fax | 520-318-3061
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | AP2122
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP2122
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License Number State | AZ
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