MEDICARE: RESILIENCE HEALTH AND WELLNESS, LLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1346926664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENCE HEALTH AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	5431 N ORACLE RD STE 104A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-0012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5431 N ORACLE RD STE 104A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-0012
Country	:	US
Telephone Number	:	520-271-6604
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	KASANDRA RODRIGUEZ
Credential	:
Telephone Number	:	520-236-6165

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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Directions to “RESILIENCE HEALTH AND WELLNESS, LLC ” Practice Location

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