MEDICARE: RICHARD ARCHULETA NP-C

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	363LF0000X	Family Nurse Practitioner	AP7514	AZ

General Provider Information

NPI Number	:	1467805770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ARCHULETA NP-C

Provider Business Mailing Address
First Line	:	9300 S WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85756-9706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 S WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85756-9706
Country	:	US
Telephone Number	:	520-663-5000
Fax Number	:

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

Provider Enumeration Date	:	07/21/2016
Last Update Date	:	07/21/2016

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