MEDICARE: ADRIENNE SUZANNE TIRRE

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	163W00000X	Registered Nurse	703397	CA
2	163WA2000X	Administrator Registered Nurse	703397	CA

General Provider Information

NPI Number	:	1548835788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE SUZANNE TIRRE

Provider Business Mailing Address
First Line	:	2333 E TAHQUITZ CANYON WAY
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-7009
Country	:	US
Telephone Number	:	760-407-5943
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 E TAHQUITZ CANYON WAY
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-7009
Country	:	US
Telephone Number	:	760-407-5943
Fax Number	:

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

Provider Enumeration Date	:	05/20/2021
Last Update Date	:	05/20/2021

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Directions to “ ADRIENNE SUZANNE TIRRE ” Practice Location

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