Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | AP8312 | AZ |
NPI | 1851757603 |
---|---|
Provider Name | Mrs. Norma Ann Bracamonte |
First Address | Tucson, AZ 85711-3629 |
Second Address | Tucson, AZ 85741-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2016 |
Last Update Date | 04/12/2018 |