1811359722 NPI number — BANNER UNIVERSITY MEDICAL CENTER TUCSON

Table of content: MRS. VIRGINIA CONNORS HERSHMAN LICSW (NPI 1154804094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811359722 NPI number — BANNER UNIVERSITY MEDICAL CENTER TUCSON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BANNER UNIVERSITY MEDICAL CENTER TUCSON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1811359722
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1501 N CAMPBELL AVE
Provider Second Line Business Mailing Address:
ROOM 4303
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85724-5070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-626-0704
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 N CAMPBELL AVE
Provider Second Line Business Practice Location Address:
ROOM 4303
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85724-5070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-626-0704
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SCHIPPERS
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
RESIDENCY PROGRAM COORDINATOR
Authorized Official Telephone Number:
520-626-0704

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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