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Organization
A NEW CREATION WOMENS CLINIC PC
Active
Organization
A NEW CREATION WOMENS CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY-LOUISE MULCAHY RN, MBA, BSN (ADMINISTRATOR)
(480) 357-3904
Entity
Organization
Contact information
Practice address
3055 W INA RD, BLDG 12, SUITE 195, TUCSON, AZ 85741-2107
(520) 293-1117
(520) 293-7701
Mailing address
3055 W INA RD, BLDG 12, SUITE 195, TUCSON, AZ 85741-2107
(520) 293-1117
(520) 293-7701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3090
AZ
363LW0102X
Women's Health Nurse Practitioner
86
AZ
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
86
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107905
—
AZ
05
—
192914
—
AZ
05
—
265722
—
AZ
05
—
293655
—
AZ
05
—
359168
—
AZ
05
—
425346
—
AZ
05
—
429971
—
AZ
05
—
582363
—
AZ
Enumeration date
05/31/2005
Last updated
11/14/2012
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