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General NPI Number Information
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NPI Number | 1730941444
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Entity Type | Individual
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Provider Name | MR. NICHOLAS CHILDRESS
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Gender | Male
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1920 W RUDASILL RD
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City | TUCSON
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State | AZ
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Zip | 85704-1076
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Country | US
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Telephone | 520-877-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 14531 GREENFIELD ML
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City | SAN ANTONIO
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State | TX
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Zip | 78254-4842
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Country | US
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Telephone | 210-643-2243
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 152972
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 970830
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 334335
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License Number State | AZ
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