Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G74304 | CA |
NPI | 1013095827 |
---|---|
Provider Name | Karen A. Reardon |
First Address | Tucson, AZ 85718 |
Second Address | Tucson, AZ 85719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 20/08/2021 |