# A NEW CREATION WOMENS CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164425450
- **Authorized official:** MARY-LOUISE MULCAHY RN, MBA, BSN (ADMINISTRATOR)
- **Authorized official phone:** (480) 357-3904

## Contact information

- **Practice address:** 3055 W INA RD, BLDG 12, SUITE 195, TUCSON, AZ 85741-2107
- **Practice address phone:** (520) 293-1117
- **Practice address fax:** (520) 293-7701
- **Mailing address:** 3055 W INA RD, BLDG 12, SUITE 195, TUCSON, AZ 85741-2107
- **Mailing address phone:** (520) 293-1117
- **Mailing address fax:** (520) 293-7701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 3090 | AZ | Yes |
| 363LW0102X | Women's Health Nurse Practitioner | 86 | AZ | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | 86 | AZ | — |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 11/14/2012

## 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 |