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NPI Code Detail

MEDICARE: MRS. CONNIE D. MARIE PARTAIN PA-C

MEDICARE: MRS. CONNIE D. MARIE PARTAIN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant4852AZ

General Provider Information

NPI Number : 1033181284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONNIE D. MARIE PARTAIN PA-C
Provider Business Mailing Address
First Line : PO BOX 43100
Second Line :
City : TUCSON
State : AZ
Zip : 85733-3100
Country : US
Telephone Number : 520-722-3777
Fax Number : 520-296-6224
Provider Business Practice Location Address
First Line : 1400 N WILMOT RD
Second Line : STE # 110
City : TUCSON
State : AZ
Zip : 85712-4498
Country : US
Telephone Number : 520-884-4999
Fax Number : 520-300-6669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 11/28/2011

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Directions to “ MRS. CONNIE D. MARIE PARTAIN PA-C” Practice Location

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