Organization
PATRIOT INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELENE P HENAGER N.P. (OWNER)
(520) 398-7079
Entity
Organization
Contact information
Practice address
9356 E RITA RD, STE 140, TUCSON, AZ 85747-6315
(520) 398-7079
(520) 207-4317
Mailing address
9356 E RITA RD, STE 140, TUCSON, AZ 85747-6315
(520) 398-7079
(520) 207-4317
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241716
—
AZ
Enumeration date
09/17/2016
Last updated
05/03/2017
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