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NPI Code Detail

MEDICARE: DR. MARLA JEAN PERRY PHD, N.P.

MEDICARE: DR. MARLA JEAN PERRY PHD, N.P.
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN023021AZ

General Provider Information

NPI Number : 1255493409
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARLA JEAN PERRY PHD, N.P.
Provider Business Mailing Address
First Line : PO BOX 70233
Second Line :
City : ORO VALLEY
State : AZ
Zip : 85737-0030
Country : US
Telephone Number : 520-624-4000
Fax Number : 520-818-5809
Provider Business Practice Location Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-624-4000
Fax Number : 520-818-5809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/08/2007

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