Individual
MR. MANNIX ISAIAS CONSOLACION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5475 S BRAIDED WASH DR, TUCSON, AZ 85747-6094
(520) 576-0348
Mailing address
2732 N ALVERNON WAY, TUCSON, AZ 85712-1804
(520) 382-3330
(520) 618-0280
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
220791
AZ
Other
Enumeration date
01/18/2019
Last updated
07/06/2021
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