1316463102 NPI number — RONDA KAY GARRIGAN FNP

Table of content: RONDA KAY GARRIGAN FNP (NPI 1316463102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316463102 NPI number — RONDA KAY GARRIGAN FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARRIGAN
Provider First Name:
RONDA
Provider Middle Name:
KAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUCHANAN
Provider Other First Name:
RONDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1316463102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 S CHERRYBELL STRA PO BOX 27292
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85726-7292
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-850-0449
Provider Business Mailing Address Fax Number:
855-711-4196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3920 S TUCSON ESTATES PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85735-1271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-850-0449
Provider Business Practice Location Address Fax Number:
855-711-4196
Provider Enumeration Date:
08/14/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  AP10352 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: RN077151 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)