MEDICARE: BERNICE SCOBIE RD

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1659906899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNICE SCOBIE RD

Provider Business Mailing Address
First Line	:	4210 N CAMPBELL AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 N CAMPBELL AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1109
Country	:	US
Telephone Number	:	520-621-0974
Fax Number	:

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

Provider Enumeration Date	:	03/09/2020
Last Update Date	:	08/23/2025

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Directions to “ BERNICE SCOBIE RD” Practice Location

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