MEDICARE: PIMA COUNTY HEALTH DEPT

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	363LC1500X	Community Health Nurse Practitioner

General Provider Information

NPI Number	:	1225891435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIMA COUNTY HEALTH DEPT

Provider Business Mailing Address
First Line	:	3950 S COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714-2099
Country	:	US
Telephone Number	:	520-724-7742
Fax Number	:

Provider Business Practice Location Address
First Line	:	2980 E AJO WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-6267
Country	:	US
Telephone Number	:	520-724-8491
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SERVICES COORDINATOR
Name	:	NIKKI L COCROFT
Credential	:
Telephone Number	:	520-724-7742

Provider Enumeration Date	:	01/31/2024
Last Update Date	:	01/31/2024

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Directions to “PIMA COUNTY HEALTH DEPT ” Practice Location

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