Organization
MARANA HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINNORAH MILLAN MEDINA NP-C (FAMILY NURSE PRACTITIONER)
(520) 256-7534
Entity
Organization
Contact information
Practice address
8181 E IRVINGTON RD, TUCSON, AZ 85709-4001
(520) 574-1551
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
RN131609
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329529
—
AZ
Enumeration date
07/18/2015
Last updated
07/18/2015
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