MEDICARE: DEBORAH MARIE WINN

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	171W00000X	Contractor	3005326	AZ

General Provider Information

NPI Number	:	1427672799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH MARIE WINN

Provider Business Mailing Address
First Line	:	PO BOX 64237
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85728-4237
Country	:	US
Telephone Number	:	520-235-1645
Fax Number	:	520-849-7595

Provider Business Practice Location Address
First Line	:	2960 N SWAN RD STE 214
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-6020
Country	:	US
Telephone Number	:	520-235-1645
Fax Number	:	520-849-7595

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

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	06/03/2020

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