Individual
MRS. MARIA J BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5295E KNIGHT DR, TUCSON, AZ 85712-2147
(520) 324-1010
(520) 324-0029
Mailing address
2325N WYATT DR 105, TUCSON, AZ 85712-2121
(520) 324-4774
(520) 324-1406
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP2996
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
319981
AHCCCS
AZ
01
—
706393
AHCCCS GROUP
AZ
01
—
Z78444
MEDICARE GROUP PTAN
AZ
Enumeration date
03/29/2008
Last updated
08/27/2015
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