Individual
MIRELY BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 S 12TH AVE, TUCSON, AZ 85713-5913
(520) 225-4317
Mailing address
2233 E EASTLAND ST, TUCSON, AZ 85719-7038
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN210337
AZ
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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