Individual
TINA AUDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 682-4111
(520) 682-3817
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
56172
AZ
208000000X
Pediatrics Physician
RS2015-0281
NM
Other
Enumeration date
03/25/2015
Last updated
05/07/2019
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