MEDICARE: MAGDELENA GRUNKEMEYER

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
1	163WS0200X	School Registered Nurse	287241	AZ

General Provider Information

NPI Number	:	1174305726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGDELENA GRUNKEMEYER

Provider Business Mailing Address
First Line	:	3939 N MAGNETITE LN
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-9167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3939 N MAGNETITE LN
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-9167
Country	:	US
Telephone Number	:	520-908-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	03/23/2026

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