MEDICARE: MS. SOPHIA E. RODRIGUES-LONERGAN BS, MA, RNCNP

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	12566	CA

General Provider Information

NPI Number	:	1497889083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SOPHIA E. RODRIGUES-LONERGAN BS, MA, RNCNP

Provider Business Mailing Address
First Line	:	2016 S 4TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-3509
Country	:	US
Telephone Number	:	520-882-4252
Fax Number	:	520-792-2835

Provider Business Practice Location Address
First Line	:	7490 S CAMINO DE OESTE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-9308
Country	:	US
Telephone Number	:	520-879-6000
Fax Number	:	520-879-6135

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	11/25/2015

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